Hypertension, ethnic origin, immigration and acculturation

Objective: To evaluate the association between ethnic origin, immigration and acculturation and the rate of hypertension. Design and method: We assessed the rate of hypertension in male workers who immigrated to Israel before 1963 and followed them through 1996 in Israel. Age at entry was 40 to 70 years. 10, 059 male municipal workers and civil servants in Israel, underwent extensive assessment in 1963, 1965 and 1968. 86% had migrated from 4 continents to the area subsequently included in Israel according to the UN decision. We evaluated the rate of hypertension as was defined by the WHO at that time (SBP>=160 or DBP>=95). We followed these individuals during their stay in Israel and evaluated the rate of hypertension during the follow-up. Results: Logistic regression yielded estimated odds ratios (ORs) of hypertension, adjusted for age and body mass index (BMI) of 1.18 (CI 95%, 1.02-1.37) and 1.37 (CI 1.17-1.61) and 1.30 (CI 1.12-1.51) among men who had migrated from Eastern Europe, Central Europe and Balkan states, respectively, compared to the non-migrants, i.e. study participants born in in 1923 or earlier at the eventual 1948 territory of Israel. Upon further adjustment for length of stay in the country since immigration, the above estimates were altered significantly. Adjusted hypertension rates for the European born men closely resembled those of the Israeli born. Conversely, the above adjustment yielded ORs of 0.87 (CI 95%, 0.76-0.99) and 0.79 (CI 0.68-0.93) for hypertension in migrants from the Mideast Asian countries and North African ones, respectively, adjusted for age and BMI and number of years in the country. Conclusions: Changes in living conditions; striving to accommodate altered targets in a multi-language society, where achievement of senior administrative and academic position may depend on acculturation; exposure to altered systems of education for the younger generation and its effects on the parents; even certain changes in dietary habits, might all play a role on health parameters, including blood pressure.