Steffen Patrick R, Smith Timothy B, Larson Michael, Butler Leon
Brigham Young University, 284 Taylor Building, Provo, Utah 84602, USA.
Psychosom Med. 2006 May-Jun;68(3):386-97. doi: 10.1097/01.psy.0000221255.48190.32.
A number of studies have documented that acculturation to western society is related to an increase in blood pressure (BP). Although there is evidence that higher socioeconomic status appears related to better cardiovascular health, increasing acculturation to western society appears related to worse cardiovascular health. The purpose of this meta-analysis was to investigate the association between acculturation and BP.
Literature searches yielded 125 relevant research manuscripts, which were coded by teams of two independent raters. This study was conducted in 2003 and 2004, and research databases such as MEDLINE and PsychINFO were searched through 2004. Measures of association (effect sizes) were extracted for both systolic blood pressure (SBP) and diastolic blood pressure (DBP) readings. Random effects models were used to analyze the resulting data.
The overall effect sizes associated with acculturation were 0.28 for SBP and 0.30 for DBP, with increasing acculturation to western society related to higher BP. More acculturated individuals had an average of 4 mm Hg higher BP than less acculturated individuals, which is similar to the effect sizes of known risk factors for high BP such as diet and physical activity. The effects of acculturation on BP appear to be universal, with similar effect sizes found across all regions of the world. Change in BP due to acculturation was not related to body mass index (BMI) or cholesterol but was related to length of residence in the new culture, with the largest effect sizes seen on initial entry and then decreasing rapidly within the first few years. Sudden cultural changes, such as migration from rural to urban settings, resulted in the largest effect sizes, which finding supports the hypothesis that the stress of cultural change is important role in the acculturation effect.
Acculturation to western society is associated with higher BP, and the distress associated with cultural change appears to be more influential than changes in diet or physical activity. Future studies would benefit from investigating how cultural change affects health and examining whether some non-Western cultural values and practices are health protective.
多项研究表明，融入西方社会与血压升高有关。尽管有证据表明较高的社会经济地位似乎与更好的心血管健康相关，但融入西方社会程度的增加似乎与更差的心血管健康相关。本荟萃分析的目的是研究文化适应与血压之间的关联。
文献检索得到125篇相关研究手稿，由两组独立评分者进行编码。本研究于2003年和2004年进行，检索了MEDLINE和PsychINFO等研究数据库直至2004年。提取收缩压（SBP）和舒张压（DBP）读数的关联度量（效应量）。使用随机效应模型分析所得数据。
与文化适应相关的总体效应量，SBP为0.28，DBP为0.30，融入西方社会程度越高，血压越高。文化适应程度更高的个体平均血压比适应程度较低的个体高4毫米汞柱，这与高血压已知风险因素如饮食和体育活动的效应量相似。文化适应对血压的影响似乎是普遍的，在世界所有地区都发现了类似的效应量。因文化适应导致的血压变化与体重指数（BMI）或胆固醇无关，但与在新文化中的居住时间有关，在最初进入时效应量最大，然后在头几年内迅速下降。突然的文化变化，如从农村迁移到城市环境，导致的效应量最大，这一发现支持了文化变化压力在文化适应效应中起重要作用的假设。
融入西方社会与较高的血压相关，与文化变化相关的困扰似乎比饮食或体育活动的变化更具影响力。未来的研究将受益于调查文化变化如何影响健康，并研究一些非西方文化价值观和习俗是否具有健康保护作用。
