ABSTRACT: One of the concomitants of the rapid socioeconomic and medical changes which occurred in American Samoa beginning with World War II has been an increase in chronic diseases, especially cardiovascular disease and diabetes. As part of the Samoan Studies Project, a 1976 survey focusing on obesity and blood pressure was conducted in American Samoa. A total of 624 men age 18 or greater were seen at that time. In 1989 we conducted a follow-up examination of 31 of these men, reassessing blood pressure, and also examining blood glucose and previously diagnosed health problems, focusing on chronic diseases such as hypertension, stroke, cancer, and diabetes. In a prospective analysis of mortality, Crews (Hum. Biol. 60:417-433, 1988) found that 111 American Samoan men who had blood pressures measured in a public health department survey in 1975 and subsequently died between 1975 and 1981, had higher average systolic and diastolic blood pressures than the 2,588 survivors (140/88 vs. 129/84). Using these data, the 1989 sample was stratified according to the 1976 blood pressure measurement of the men and a sample of 14 normotensive men (1976 blood pressure <140/90) and 17 hypertensives (1976 blood pressure >140/90) was selected.
The average age, weight, and number of cigarettes smoked per day was not significantly different for these two groups at the 12-year follow-up. However, several indicators of health status did differ. The hypertensive group had significantly higher systolic and diastolic blood pressures (P < 0.001). Additionally, the hypertensive group had higher random blood glucose values (P ~ 0.005) and were significantly more likely to be hypertensive and/or have impaired glucose tolerance (P < 0.001). Change in weight was predictive of change in blood pressure, but not of absolute value of blood pressure. This paper notes the importance of elevated blood pressure as a predictor of future chronic disease risk for Samoan men.