Hollenberg N K, Martinez G, McCullough M, Meinking T, Passan D, Preston M, Rivera A, Taplin D, Vicaria-Clement M
Brigham and Women's Hospital, Boston, MA 02115, USA.
Hypertension. 1997 Jan;29(1 Pt 2):171-6. doi: 10.1161/01.hyp.29.1.171.
The indigenous Kuna who live on islands in the Panamanian Caribbean were among the first communities described with little age-related rise in blood pressure or hypertension. Our goals in this study were to ascertain whether isolated island-dwelling Kuna continue to show this pattern, whether migration to Panama City and its environs changed the patterns, and whether the island-dwelling Kuna have maintained their normal blood pressure levels despite partial acculturation, reflected in an increased salt intake. We enrolled 316 Kuna participants who ranged in age from 18 to 82 years. In 50, homogeneity was confirmed by documentation of an O+ blood group. In 92 island dwellers, diastolic hypertension was not identified and blood pressure levels were as low in volunteers over 60 years of age as in those between 20 and 30 years of age. In Panama City, conversely, hypertension prevalence was 10.7% and exceeded 45% in those over 60 years of age (P < .01), blood pressure levels were higher in the elderly, and there was a statistically significant positive relationship between age and blood pressure (P < .01). In Kuna Nega, a Panama City suburb designed to maintain a traditional Kuna lifestyle but with access to the city, all findings were intermediate. Sodium intake and excretion assessed in 50 island-dwelling Kuna averaged 135 +/- 15 mEq/g creatinine per 24 hours, exceeding substantially other communities free of hypertension and an age-related rise in blood pressure. Despite partial acculturation, the island-dwelling Kuna Indians are protected from hypertension and thus provide an attractive population for examining alternative mechanisms.
居住在巴拿马加勒比海岛屿上的库纳原住民是最早被描述为血压几乎没有与年龄相关的升高或高血压的群体之一。我们在这项研究中的目标是确定与世隔绝的岛屿库纳人是否继续呈现这种模式，迁移到巴拿马城及其周边地区是否改变了这种模式，以及尽管有部分文化适应现象（表现为盐摄入量增加），岛屿库纳人是否仍维持其正常血压水平。我们招募了316名年龄在18至82岁之间的库纳参与者。其中50人通过记录O+血型确认了同质性。在92名岛屿居民中，未发现舒张期高血压，60岁以上志愿者的血压水平与20至30岁者一样低。相反，在巴拿马城，高血压患病率为10.7%，60岁以上者超过45%（P <.01），老年人血压水平更高，年龄与血压之间存在统计学上显著的正相关关系（P <.01）。在库纳内加，一个旨在维持传统库纳生活方式但可通往城市的巴拿马城郊区，所有结果均处于中间水平。对50名岛屿库纳居民的钠摄入量和排泄量评估显示，平均每24小时为135±15毫当量/克肌酐，大大超过了其他无高血压且血压无年龄相关升高的群体。尽管有部分文化适应现象，岛屿库纳印第安人仍免受高血压影响，因此为研究替代机制提供了一个有吸引力的群体。
