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Acculturation and coronary heart disease among Japanese men in Hawaii
Insights
Acculturation, or adopting new cultural behaviors, was linked to coronary heart disease prevalence in Japanese men in Hawaii. Traditional lifestyles correlated with lower heart disease risk factors and prevalence.
Area of Science:
- Cardiovascular epidemiology
- Sociology of health
- Behavioral science
Background:
- Coronary heart disease (CHD) risk factors are influenced by lifestyle and cultural factors.
- Acculturation, the process of cultural and psychological change, may impact health behaviors and outcomes.
- The Honolulu Heart Program provides a unique cohort for studying CHD in Japanese-American men.
Purpose of the Study:
- To investigate the association between acculturation and the prevalence and incidence of coronary heart disease (CHD).
- To examine how acculturation relates to traditional CHD risk factors in a Japanese-American male cohort.
Main Methods:
- Analysis of data from 4653 Japanese-American men in Hawaii (Honolulu Heart Program, 1971-1979).
- Assessment of acculturation using four scales, examining associations with CHD prevalence and incidence.
- Multivariate analyses controlling for 11 established CHD risk factors.
Main Results:
- Two acculturation scales were significantly associated with CHD prevalence, independent of other risk factors.
- No significant association was found between acculturation scales and CHD incidence, potentially due to inclusion of fatal cases.
- More traditional Japanese men exhibited lower serum cholesterol, lower uric acid, less obesity, higher physical activity, and lower cigarette smoking rates.
Conclusions:
- Acculturation is associated with CHD prevalence in Japanese-American men, mediated by traditional risk factors.
- Lifestyle changes accompanying acculturation play a role in cardiovascular health.
- Further research is needed to clarify the relationship between acculturation, CHD incidence, and mortality.
Abstract:
A cohort of 4653 men of Japanese ancestry living in Hawaii, with traditional Japanese social and cultural lifestyles, were studied for the association of the prevalence and incidence of coronary heart disease (Honolulu Heart Program, 1971-1979). Two of four scales of acculturation were significantly associated with coronary heart disease prevalence independently of 11 other risk factors, but none of the acculturation scales were associated with incidence appeared to be mostly due to the inclusion of fatal cases in the incidence data, although other explanations are possible. Measures of acculturation were also significantly associated wih many of the other coronary heart disease risk factors in such a way that the more traditional Japanese men had lower serum cholesterol and uric acid, were less obese, more physically active, and smoked fewer cigarettes than the more westernized men. A comparison of bivariate and multivariate analyses indicated that some of acculturation scales were indirectly associated with coronary heart disease because of the confounding association with the other risk factors.