Objectives: To compare the prevalence of cardiovascular diseases and risk factors in Holocaust survivors with that of Jewish immigrants from Europe and America. Design: Population-based, cross-sectional study. Setting: Clalit, a large Israeli healthcare provider. Participants: Holocaust survivors (n=83,971) and a comparison group of Jewish individuals born in North or South America or European countries not under Nazi occupation or who immigrated to Israel before 1939 (n=16,058) (mean age 84±7, 61% female). Measurements: Univariate and multivariable logistic regression analyses of cardiovascular diseases and risk factors. Matching the comparison group to Holocaust Survivors on propensity scores for exposure. Results: The prevalence of ischemic heart disease (38.7% vs 31.3%), congestive heart failure (10.9% vs 9.1%), past stroke (15.7% vs 13.4%), and peripheral vascular disease (9.5% vs 7.9%) was higher in Holocaust survivors (p<.001 for all comparisons). Similar results were found for cardiovascular risk factors (diabetes mellitus (14.4% vs 13.6%), hypertension (89.3% vs 86.4%), dyslipidemia (75.9% vs 74.0%) (p<.001 for all comparisons). In multivariable analysis, matched on propensity scores and controlled for confounders, odds ratios for men and women were higher for diabetes (1.23, 1.55), dyslipidemia (1.53, 1.51), hypertension (1.56, 1.94), stroke (1.18, 1.17), and ischemic heart disease (1.18, 1,40), but not congestive heart failure (0.95, 1.02). A Positive association was noted for peripheral vascular disease in males (1.20) but not females (0.96). Conclusion: Prevalence of cardiovascular diseases and risk factors was higher in Holocaust survivors. These associations were stronger in women in most cases.
Bibliographical noteFunding Information:
This study was conducted as part of the requirements for graduation from the Goldman Medical School at the Faculty of Health Sciences, Ben-Gurion University of the Negev. Conflict of Interest: The authors have no conflicting nor competing interests to declare. Author Contributions: Zamstein, Dreiher: study concept and design, establishing scientific background, data analysis and interpretation, initial draft of manuscript, manuscript revision. Biderman, Sherf, Ben David: study concept and design, interpretation of results, critical revision of manuscript. All authors read and approved the final manuscript. Sponsor's Role: Not applicable.
© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society
- cardiovascular diseases
- cardiovascular risk factors
ASJC Scopus subject areas
- Geriatrics and Gerontology