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Cited by 204Blood Pressure and Hypertension StudiesRacial and Ethnic Identity ResearchSodium Intake and Health

Acculturation to western society as a risk factor for high blood pressure: a meta-analytic review

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Steffen, Patrick R., Smith, Timothy B., Larson, Michael, Butler, Leon·2006·Psychosomatic Medicine
DOI 10.1097/01.psy.0000221255.48190.32
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Abstract

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

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  • Lifestyle changes associated with greater modernization contribute to hypertension, obesity and their sequelae.

    “A large literature supports the notion that lifestyle changes associated with greater modernization contribute to hypertension, obesity and their sequelae, despite reduced incidence of infectious disease and potentially greater access to healthcare ([16] and refs therein).”

    From Physical Activity and Modernization among Bolivian Amerindians (2013) · cites this paper as [16]

  • These patterns in the Bolivian Amazon contrasts with those observed elsewhere, where in the span of only a few decades, intense market integration has led to changes in body size, activity, and risk factors for chronic disease.

    “These patterns in the Bolivian Amazon contrasts with those observed elsewhere, where in the span of only a few decades, intense market integration has led to changes in body size, activity, and risk factors for chronic disease [16], [51], [52], [53].”

    From Physical Activity and Modernization among Bolivian Amerindians (2013) · cites this paper as [16]

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Research works printed but not linked: 12

  1. Donnison CP, Lond BS. Blood pressure in the African native. Lancet 1929;1:6-7.
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  4. Cooper R, Rotimi C, Ataman S, McGee D, Osotimehin B, Kadiri S, Muna W, Kingue S, Fraser H, Forrester T, Bennett F, Wilks R. Am J Public Health 1997;87:160-8.
  5. Baker PT. Un studio de los aspectos biologicos y socials de la migracion Andina. Arch Biol Andina 1977;7:63-82.
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  7. Bursztyn M, Raz I. Blood pressure and insulin in Ethiopian immigrants: longitudinal study. J Hum Hypertens 1995;9:245-8.
  8. Cruz-Coke R, De La Barrera C. Presion arterial en natives de Isla de Pascua. Rev Med Chile 1981;109:99-102.
  9. Elder JP, Woodruff SI, Candelaria J, Goldbeck AL, Alvarez JL, Criqui JH, Norquist CD, Rupp JW. Socioeconomic indicators related to cardiovascular disease risk factors in Hispanics. Am J Health Behav 1998;22:172-85.
  10. Grossman E, Rosenthal T. Effect of urbanization on blood pressure in Ethiopian immigrants. J Hum Hypertens 1993;7:559-61.
  11. Haffner SM, Mitchell BD, Valdez RA, Hazuda RA, Hazuda HP, Morales PA, Stern MP. Eight-year incidence of hypertension in Mexican-Americans and Non-Hispanic Whites. Am J Hypertens 1992;5:147-53.
  12. Hansen H. Acculturation, social support, and hypertension in elderly Mexican-American women [Ph.D. Psychology Dissertation]. Palo Alto CA: Pacific Graduate School of Psychology; 1996.

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Authors
Steffen, P. R., Smith, T. B., Larson, M., & Butler, L.
Affiliations
Brigham Young University (US)
Corresponding author
Steffen, Patrick R.
ORCID
Venue
Psychosomatic Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2006-05
Volume
68
Issue
3
Pages
386-397
ISSN
0033-3174 (ISSN-L)
DOI
10.1097/01.psy.0000221255.48190.32
OpenAlex
W2025709143
Cited by
204
References
171
Citations by year
2026: 3 · 2025: 2 · 2024: 5 · 2023: 4 · 2022: 7 · 2021: 7 · 2020: 7 · 2019: 15 · 2018: 9 · 2017: 12 · 2016: 9 · 2015: 18 · 2014: 16 · 2013: 19 · 2012: 17
FWCI
1.50
Type
journal article
Language
en
Open access
Locations
  • Psychosomatic Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • ScholarsArchive (Brigham Young University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Keywords
acculturation, hypertension, systolic blood pressure, diastolic blood pressure, cultural change, stress, migration, length of residence, cardiovascular risk factors, body mass index, cholesterol, diet, physical activity
MeSH terms
Acculturation, Adult, Blood Pressure, Female, Humans, Hypertension, Male, Risk Factors, Social Class, Stress, Psychological, Health Behavior, Western World

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