Heart disease in a migrating population

Abstract

Anthropometric and biochemical data were collected on 419 Samoan adults representing unacculturated, acculturated and migrant populations with the aim of isolating risk factors associated with a documented rise in heart disease in westernized Samoan populations. Analysis of data revealed that acculturation results in a more atherogenic lipid profile with respect to cholesterol, HDL cholesterol and triglycerides. Acculturated males also show an increase in blood pressure, insulin and obesity when compared with the more traditional group, though these differences are not so distinct in females. The results were interpreted as indicating changes in diet and activity pattern most likely responsible for the alterations in acculturated males whereas a change in diet alone could account for female differences. Migration was found to make no significant change in the likelihood of acculturated Samoans developing heart disease. Cholesterol and blood pressure as indicators of stress were found to be slightly lower in migrants than Samoans living in Tutuila. It is hypothesized that alternative coping behaviors may be available to migrants responding to stress in a non-traditional situation. A negative correlation was demonstrated between HDL cholesterol and fasting insulin levels in all populations examined after controlling for age, place, sex and obesity. It is proposed that this may be a fundamental relationship in the pathogenesis of heart disease.