Relationship between blood pressure and modernity among Ponapeans

In the Micronesian island of Ponape blood pressures were found in 1947 and again in 1953 to be very low and to show no difference between age groups. As part of the US Trust Territory of the Pacific from 1945, the island had begun to change in the direction of modernity, the changes being most dramatic in the capital town of Kolonia, but no part of the island being unaffected. After a generation of modernization, a cross-sectional study was done to assess the impact of changing way of life on blood pressure. Communities were sampled at three levels of impact of modernization: the capital town of Kolonia, an intermediate area, and a remote area. No differences in salt intake were found for the three areas; but the population in the most modern area was younger and heavier. No consistent ecological differences were found in blood pressure level. Since there is considerable variation in modernity within each area, a Guttman-type scale of individual modernity was developed. No trends of variation of blood pressure with modernization were found to be consistent for both sexes and all areas. However, among males in the most modern area both systolic and diastolic pressures increased consistently with increasing modernity, controlling for age. For diastolic pressures, significant increases were found for all males, Kolonia males, and intermediate area males. When body mass as well as age were controlled, the strength of the trends decreased. But among Kolonia males the increase of diastolic pressure with increasing modernity remained highly significant; that of systolic pressure, marginally significant.