Heterogeneity of the blood pressure distribution among Solomon Islands societies with increasing acculturation

Abstract

This study illustrates the very complex nature of gene by environmental interactions influencing the blood pressure (BP) distribution in a series of genetically distinctive populations undergoing rapid acculturation. We report the results of two BP and anthropometric surveys on Solomon Islands societies separated by an interval of 14 to 19 years. While differences in acculturation existed at the time of the initial survey, the interval between surveys was marked by rapid acculturation in almost all societies. Seven of the eight societies originally covered were included in the resurvey, and a large but variable proportion of the original sample subjects was recovered in the follow-up. Because the genetic relationships of the societies have been described, we were able to establish the following points concerning the role of genetic differences in determining the distribution of BP among these populations and, more important, the interaction of these genetic differences with changes associated with increasing acculturation: 1) In the initial survey, mean adjusted systolic and diastolic BPs were significantly heterogeneous among societies within and among genetically related clusters of societies (genetic clusters) and sexes. At the same time, rank differences in these means were not associated with rank differences in acculturation status among societies ignoring cluster membership. 2) Importantly, in the follow-up survey increasing acculturation resulted in the disappearance of significant differences in mean systolic and diastolic BP among genetic clusters in males , despite continued significant heterogeneity among societies within genetic clusters. In females, differences among genetic clusters persisted, but the degree of significance was substantially less with increasing acculturation. We interpret these changes as evidence for genotype by environment interaction. 3) There were significant differences in interindividual variances of both systolic and diastolic BPs among genetic clusters in the first survey. Ranks of these variances were not significantly associated with acculturation rank. In the follow-up survey, however, most societies showed striking increases in the variance of both systolic and diastolic BPs with increased acculturation. These increases in variance of both systolic and diastolic BPs may be related to a) shifts in demography and/or anthropometry of some societies; b) increased range and intensity of environmental factors affecting BP and associated with increased acculturation; and/or c) genotype by environmental interactions. 4) The correlation between systolic and diastolic BP decreased over the interval for all societies within and among genetic clusters. This trend was partly the result of larger changes in variances for systolic than diastolic BP in the resurveys. This study illustrates the enormous heterogeneity in the BP distribution that can occur even among populations with relatively similar ethnic and cultural backgrounds.