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Blood pressure of Amerindians from Surinam.

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Blood Pressure of Amerindians from Surinam
E. V. GLANVILLE AND R. A. GEERDINK
Department of Sociology and Anthropology, McMaster University,
Hamilton, Ontario, Canada, and Department of Medicine,
Stichting Academisch Ziekenhuis, Catharijnesingel 101,
Utrecht, The Netherlands
K E Y WORDS
Blood pressure . Amerindians . Surinam.
ABSTRACT
Blood pressures of members of the Trio and Wajana tribes from
Surinam have been analysed in relation to age, stature and weight. The sample is representative of a group living in a hunting and gathering economy but
beginning to come into jarring contact with an alien culture. Diastolic pressure
does not alter significantly with age in adults of either sex. There is a small
but significant increase in systolic pressure with age in adult females but in
males there is an apparent decrease. This decrease is probably an artifact of
the cross-Sectional survey approach. The high pressure in some young adults
is discussed with reference to psychosocial stress. Mean blood pressures are
given for children from five years of age onwards.
Blood pressure of Amerindians of the
Trio and Wajana tribes of Surinam are
presented. The data have been analysed
in relation to age, stature and weight.
Data were collected in 1967 and 1968
at sites on the Upper Courantyne, Lawa
and Tapanahony rivers where missions
had recently been established. Indians
drifted in and out of the settlement areas
and were measured as they came by. They
were not resident at the missions. Further information can be found in an earlier publication (Glanville and Geerdink,
'70). The population studied supported
themselves largely by hunting and gathering and their nutritional status can be
considered to be representative of a group
living under primitive conditions in a
favorable environment. In general they
were healthy and fit. Blood protein studies indicated the absence of admixture
with non-Amerindian groups.
METHODS
Age, weight and stature were determined as described previously (Glanville
and Geerdink, '70).
Blood pressures were measured with a
mercury sphygmomanometer. The patient
was seated, resting his ann on a support.
The cuff was pumped up evenly until the
radial pulse could no longer be felt. The
AM. J. PHYS. ANTHROP.,37: 251-254.
pressure at the first audible sound as the
cuff was slowly deflated was read as systolic, that at the disappearance of sounds
as diastolic. The cuff was left in position
for some time before final readings were
taken. Pressures were measured at the
end of a general medical examination but
before anthropometric measurements and
blood samples were taken. Each subject
was examined only once, the examination
usually taking place out of doors in a
familiar shaded place and in the presence
of other members of his group. Every
effort was made to put the subject at his
ease. All measurements were made by an
experienced physician (R.G.).
Data were analysed using standard linear regression techniques and tests of
significance. Regressions were calculated
using ungrouped (metric) data.
RESULTS
No significant difference in blood pressure was observed between members of
the two tribes. As both tribes live under
very similar environmental conditions the
data were pooled.
Mean values of those traits with which
we are presently concerned are set out
in table 1.
I Collection of data was made possible by a grant from
the Netherlands Foundation for the Advancement of
Tropical Research (WOTRO), The Hague, No. W 92-2.
251
252
E. V. GLANVILLE A N D R. A. GEERDINK
Diastolic pressure in adult males also
shows a negative coefficient with age but
it is not significantly different from zero
at the 1% level.
In adult females, both systolic and diastolic pressures tend to increase with age
but the slope of the regression is significantly different from zero only in the case
of systolic. As in males, regression on age
explains only a very minor part of the
sample variation (R2 = 0.055 and 0.003
for systolic and diastolic pressures, respectively).
The effects of age on blood pressure
can be seen from the grouped data in
table 2 . After a gradual rise in pressure
during childhood and adolescence mean
pressures tend to reach a plateau during
adult life. The regression coefficients for
pressure on age are given in table 3 for
the adult sample. Taking first the male
data, systolic pressure shows a small but
statistically significant decline with age.
A decline is surprising and seems to be
due to the presence of a number of individuals with relatively high pressures in
the 20 to 23 year age range. The value
of RS (table 3) suggests that only some
5% of the sample variation in systolic
pressure in adult males can be accounted
for on the basis of age.
Stature
By European standards the people are
small, the males averaging only 62 inches
and the females 58 inches (table 1). The
correlation of blood pressure with stature
TABLE 1
Characteristics of the adult sample (age 20 and over)
Male sample
A g e (yrs)
Weight (kgs)
(1bs)
Stature ( c m s )
(ins)
Systolic pressure
Diastolic pressure
Female sample
Number
Mean
S.D.
Number
Mean
S.D.
169
144
144
168
168
169
169
34.6
59.0
130.1
157.4
62.0
118.6
77.1
11.1
6.8
15.0
4.8
1.9
12.3
8.9
217
196
196
217
217
21 7
217
34.4
49.6
109.3
147.0
57.9
113.6
73.6
12.1
6.1
13.4
4.8
1.9
14.6
10.0
TABLE 2
Mean blood pressure by age group
Male sample
Age
group
5-6
7-8
!+lo
11-12
IS14
1516
17-18
19-20
21-25
26-30
31-35
36-40
41-45
46-50
51-55
5640
61-over
Systolic
Number
10
15
13
8
17
11
11
11
35
35
20
17
19
18
12
3
2
Mean
93.5
99.7
105.8
110.6
113.2
118.2
122.7
123.6
125.7
116.7
112.8
116.5
118.7
116.7
113.3
120.0
117.5
Female sample
Diastolic
S.D.
6.2
8.3
9.8
8.9
11.8
~~
11.7
15.7
13.8
13.2
11.9
10.1
11.7
9.4
11.9
10.7
13.2
3.6
Mean
60.1
62.7
68.8
73.8
75.0
71.4
76.8
84.5
78.3
78.0
72.3
75.6
76.6
78.9
76.7
71.7
70.0
S.D.
6.9
7.8
9.4
6.4
11.2
9.0
9.0
12.6
10.9
8.7
8.3
7.7
5.8
7.2
6.2
7.7
14.1
Systolic
Number
Mean
S.D.
8
16
12
7
9
6
14
18
47
47
31
21
12
18
16
5
8
100.0
105.3
109.2
113.6
114.4
110.8
116.4
116.4
111.3
109.7
111.6
112.6
113.3
112.5
131.8
111.0
123.1
16.0
11.3
15.2
14.0
14.4
5.9
6.9
13.3
9.9
11.8
12.4
11.8
14.2
16.7
23.1
11.9
17.7
Diastolic
Mean
65.0
65.6
71.7
71.4
76.7
71.7
74.6
75.6
72.6
71.3
74.2
73.8
74.6
72.8
77.8
72.0
71.9
S.D.
14.1
8.9
12.9
4.8
9.4
5.2
9.5
9.1
8.8
9.2
9.5
10.0
10.9
15.6
10.0
12.5
4.6
253
BLOOD PRESSURE OF AMERINDIANS
is low and only in the case of systolic
pressure in males does the regression coefficient approach statistical significance.
correlation with weight but diastolic pressures do show small yet significant positive regression coefficients in both sexes.
However, the value of R2 is very small
(0.028 and 0.022 in males and females,
respectively).
Weight
The population is well nourished but
there is no tendency towards obesity. SkinMultiple regression
fold thickness tends to remain stable
throughout adult life (Glanville and GeerThe combined effect on blood pressure
dink, '70).
of age, stature and weight can be seen
Systolic pressures show no significant in table 4.
TABLE 3
Linear regression of blood pressure o n age, stature a n d w e i g h t . T h e regression coefficient ( r ) , its
standard error ( S . E . ) and tl7e c o n s t a n t of t h e regression m o d e l
rx are s h o w n A d u l t s a m p l e
y = a
+
n
Systolic on:
Ag e
Weight
Diastolic on:
Age
Stature
F
R2
0.2819
0.083
0.080
127.3
103.9
2.99 2
3.53 2
8.93
12.45 2
0.0505
0.0545
d
0
168
217
0.3454
0.1742
0.195
0.207
64.2
87.9
1.78
0.84
3.15
0.71
'
0.0185
0.0033
d
144
196
0.0249
0
- 0.0104
0.155
0.169
117.5
114.4
0.16
0.06
0.03
0.01
0.0002
0.0000
d
169
- 0.1062
9 217
0.0413
0.061
0.056
80.8
71.9
1.73
0.74
3.01
0.54
0.0176
0.0025
168
217
0.1896
0.2254
0.140
0.141
47.2
40.1
1.35
1.60
1.83
2.54
0.0108
0.01 16
144
196
0.21 75
0.2328
0.108
0.112
65.1
62.1
2.02
2.07
d
9
I
t
- 0.2494
?
2
Constant
169
217
d
Weight
S.E.
0
d
Stature
r
4.06
4.30
I
I
2
0.0276
0.0216
Significant at 5% level.
Significant a t 1% level.
TABLE 4
Pnrtial regression coefficients of blood pressure o n age, stahire a n d w e i g h t .
A d u l t m a l e s ( n = 144) a n d f e m a l e s ( n = 197)
Systolic pressure
r
S.E.
Diastolic pressure
t
r
S.E.
t
~~
Age
Stature
d -0.2155
? 0.3088
0.0966
0.0856
2.230
3.605
- 0.1742
0.0365
0.0669
0.0589
2.604
0.619
d
0.2605
0.2174
1.029
1.474
0.0535
0.1172
0.1803
0.1495
0.297
0.784
0.1869
0.1751
0.511
0.216
0.1794
0.2189
0.1294
0.1204
1.387
1.817
R?
Constant
0.0442
0.0704
64.83
44.28
?
Weight
0.2681
0.3205
d -0.0954
0
0.0379
Constant
d
0
I
2
89.67
54.32
Significant a t 5 4 level.
Significant at 1 % level.
F
2.157
4.871 2
F
3.568 I
1.741
Rz
0.0710
0.0263
254
E. V. GLANVILLE AND R. A. GEERDINK
The inclusion of stature and weight
modifies to only a minor degree the coefficients of blood pressure on age. However, the association of diastolic pressure
with weight now falls below the level of
statistical significance in both sexes.
The combined effect of age, stature and
weight accounts for only some 2 to 7%
of the variation i n blood pressure leaving
the great majority of the variations unexplained by the factors considered in the
present paper (R2 = 0.071 and 0.026 in
males and females, respectively).
DISCUSSION
Numerous studies have demonstrated
the presence of age-stable and relatively
low blood pressures among diverse populations living under so-called primitive
conditions (for Amerindian data see de
Lima, '50; Kean, '44; Lowenstein, '61;
Neel et al., '64). Variation in systolic
pressure has been linked variously with
diet, obesity, exercise, climate, disease,
heredity, smoking, stress and psychosocia1 factors.
With regard to diet it may be noted that
the Trio and Wajana are hunters and
gatherers living in temporary settlements
along the river banks. Their diet is rich i n
protein from animals and fish but relatively low in carbohydrate. They do not
smoke tobacco.
Clinical signs of hypertension were not
observed in the population. The highest
systolic pressures were observed among a
number of women in the 51 to 55 year
age group on the one hand and among
young men in their early 20's on the other.
However, no individual showed clinical
signs of hypertension.
Turning now to consider the possible
role of psychosocial factors, we may note
that only i n the one to six years (depending on the group) before these observations were made did the population begin
to come into jarring contact with a n alien
culture. Traditional beliefs and practices
were still strong but the strictures of the
Baptist missionaries were beginning to be
a source of social stress. It is not clear
which age groups and which sex were the
first to feel the stress of social change.
One such group may have been the young
men, as has been observed among the
Ojibwa by Hallowell ('55). If elevated
blood pressure is a response first appearing in the young men then the apparent
decline in pressure with age shown by
the data is a n artifact of the cross-sectional approach of the present survey.
It is interesting that an apparent decline
with age has been observed in a number
of studies. All were of small traditionallyoriented groups in which the younger persons were experiencing conflict between
the attractions of the new and loyalty to
parental traditions (Henry and Cassel, '69).
LITERATURE CITED
de Lima, P. E. 1950 Niveis tensionais dos Indios
Kalapalos e Kamaiura. Rev. Brasil. Med., 7 :
787-788.
Glanville, E. V., and R. A. Geerdink 1970 Skinfold thickness, body measurements and age
changes i n Trio and Wajana Indians of Surinam. Am. J. Phys. Anthrop., 32: 455461.
Hallowell, A. I. 1955 Culture and Experience.
U. of Pennsylvania Press.
Henry, J. P., and J. C. Cassel 1969 Psychosocial factors in essential hypertension. Am. J.
Epidemiology, 90: 171-200.
Kean, B. H. 1944 Blood pressure of the Cuna
Indians. Am. J. Trop. Med., 24: 341-343.
Lowenstein, F. W. 1961 Blood pressure in relation to age and sex i n the tropics and subtropics. Lancet, 1 : 389-392.
Neel, J. V., F. M. Salzano, P. C. Junqueira, F.
Keiter and D. Maybury-Lewis 1964 Studies
on the Xavante Indians of the Brazilian Mato
Grosso. Am. J. Hum. Genet., 16: 52-140.
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