Kuhrs et al. BMC Public Health 2012, 12:190 http://www.biomedcentral.com/1471-2458/12/190 R E S E A R C H A R T I C L E Open Access Risk factors for cardiovascular and cerebrovascular diseases among ethnic Germans from the former Soviet Union: results of a nested case-control study Ema Kuhrs*, Volker Winkler and Heiko Becher Abstract Background: Diseases of the circulatory system (CVD) are the most common causes of death in developed countries. However, the prevalence of CVD varies between countries; for example, the mortality rate in Russia is about four times higher than in Western Europe. In a recent retrospective cohort study it was unexpectedly found that CVD mortality is lower among “Aussiedler” (ethnic Germans from the former Soviet Union) compared to the German population. Methods: This is a case-control study, nested into a recent cohort study of migrants from the former Soviet Union. Relatives of cases and controls themselves were interviewed by telephone using a standardized questionnaire. To estimate relative risks via the odds ratio (OR), a conditional logistic regression procedure was performed. Results: Commonly known risk factors for CVD were identified as relevant to Aussiedler. The best multivariate model for CVD includes five risk factors: consumption of alcohol, smoking, diabetes, cholesterol and consumption of sweets. For alcohol consumption and smoking, OR = 3.68 (95% CI, 1.58-8.58) and OR = 3.07 (95% CI, 1.42-6.62), respectively. For diabetes mellitus and high cholesterol values, OR = 3.29 (95% CI, 1.50-7.39) and OR = 2.32 (95% CI, 1.11-4.88), respectively. The almost complete abdication of sweets is associated with a protective effect, OR = 0.34 (95% CI, 0.18-0.64). The prevalence of risk factors is somewhat different to that of the autochthon German population and partly explains the differences in CVD mortality between both groups. Conclusions: The reported lower prevalences of known risk factors of CVD such as alcohol consumption, high cholesterol, diabetes and smoking (in women) could contribute to a lower risk of CVD. Keywords: Nested case-control study, Risk factors, CVD-Mortality, Migrants, Aussiedler, Soviet Union Background Migration is an old phenomenon that continues to this day. Germany is a country of destination for migrants from many different parts of the world, and migrants con- stitute 9% percent of the total population of Germany [1]. The study of migrant health is an important challenge in health care. Migrants are often subject to different risks and can differ in their health awareness and behavior than the population of the host country, and consequently can have different morbidity and mortality [2]. * Correspondence: kuhrs@uni-heidelberg.de Institute of Public Health, University of Heidelberg, Im Neuenheimer Feld 324, Heidelberg 69120, Germany Between 1950 and 2009, approximately 4.5 million migrants came to Germany (Figure 1). Of these, more than two million came from the territory of the former Soviet Union [3]. They are ethnic Germans, so called “Aussiedler” or “Spätaussiedler” (resettlers). To date, little reliable information about the health behavior of migrants from the countries of the former Soviet Union is available in epidemiological studies [4,5]. Studies on the migration itself and its impact on health are of great interest, as it is acknowledged that there is a connection between health and migration [6]. This can be due to communication problems and past experi- ences that change attitudes to health and disease [7-9]. © 2012 Kuhrs et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.