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Original research
Coronary heart disease and stroke in the Sami and non-Sami populations in rural Northern and Mid Norway—the SAMINOR Study
  1. Susanna R A Siri1,
  2. Bent M Eliassen2,
  3. Ann R Broderstad1,3,
  4. Marita Melhus1,
  5. Vilde L Michalsen1,
  6. Bjarne K Jacobsen1,
  7. Luke J Burchill4 and
  8. Tonje Braaten1
  1. 1Department of Community Medicine, Centre for Sami Health Research, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway
  2. 2Faculty of Nursing and Health Sciences, Nord University, Bodo, Nordland, Norway
  3. 3Department of Medicine, University Hospital of North Norway, Harstad, Troms, Norway
  4. 4Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Susanna R A Siri; susanna.r.siri{at}uit.no

Abstract

Background Previous studies have suggested that Sami have a similar risk of myocardial infarction and a possible higher risk of stroke compared with non-Sami living in the same geographical area.

Design Participants in the SAMINOR 1 Survey (2003–2004) aged 30 and 36–79 years were followed to the 31 December 2016 for observation of fatal or non-fatal events of acute myocardial infarction (AMI), coronary heart disease (CHD), ischaemic stroke (IS), stroke and a composite endpoint (fatal or non-fatal AMI or stroke).

Aim Compare the risk of AMI, CHD, IS, stroke and the composite endpoint in Sami and non-Sami populations, and identify intermediate factors if ethnic differences in risks are observed.

Methods Cox regression models.

Results The sex-adjusted and age-adjusted risks of AMI (HR for Sami versus non-Sami 0.99, 95% CI: 0.83 to 1.17), CHD (HR 1.03, 95% CI: 0.93 to 1.15) and of the composite endpoint (HR 1.09, 95% CI: 0.95 to 1.24) were similar in Sami and non-Sami populations. Sami ethnicity was, however, associated with increased risk of IS (HR 1.36, 95% CI: 1.10 to 1.68) and stroke (HR 1.31, 95% CI: 1.08 to 1.58). Height explained more of the excess risk observed in Sami than conventional risk factors.

Conclusions The risk of IS and stroke were higher in Sami and height was identified as an important intermediate factor as it explained a considerable proportion of the ethnic differences in IS and stroke. The risk of AMI, CHD and the composite endpoint was similar in Sami and non-Sami populations.

  • coronary artery disease
  • genetics
  • risk factors
  • stroke
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Footnotes

  • Correction notice This paper has been updated since first published to update the Key Questions box.

  • Contributors TB and BME: conceived the study. MM: linked the different data sources and prepared the research dataset for STATA. SRAS: performed the analyses, wrote the manuscript and made the tables. TB, BKJ and VLM: assisted with statistical analyses and the interpretations of the statistics. VLM: made the figure. All authors critically revised the manuscript, tables and figures, and contributed to drawing the final conclusions.

  • Funding The first authors PhD was funded by the Centre for Sami Health Research at UiT The Arctic University of Norway. SAMINOR 1 was financed by the Norwegian Ministry of Health and Care Services.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The present study (2015/2204–11) is approved by the Regional Committee for Medical and Health Research Ethics for region North (REC North) and by the SAMINOR Project Board. We included those who gave written informed consent to have their data linked to registries, and the data were deidentified before they were available for analyses. The SAMINOR is part of the SAMINOR Study that is approved by The Norwegian Data Inspectorate and the REC North.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement In this study, we have used de-identified participant data which is not available for the public, as it is restricted by licence. Data might, however, be available if a written request is sent to and accepted by the SAMINOR Project Board (www.saminor.no) and by the Regional Committee for Medical and Health Research Ethics for region North.

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