Blood pressure, serum cholesterol and nutritional state in Tanzania and in the Amazon: Comparison with an Italian population

Objective. To confirm that westernization of dietary habits represents a stimulus for the expression of cardiovascular risk. Design. Three representative age- and sex-matched samples of general populations of three continents were compared cross-sectionally by analysis of variance. Participants. In total 1110 subjects aged 22-89 years, divided into three groups (370 from Tanzania and Uganda, 370 from the Amazonian region of Brazil, and 370 from northern Italy; 111 men and 259 women in each group). Results. The blood pressure of Africans eating a low-salt 'fish and vegetable' diet was lower than those of Brazilians, whose diet was based on cereals and meat, and highly urbanized Italians. The systolic blood pressure was correlated to the body mass index for all three populations, but with age only for the Brazilians and Italians. The total cholesterol level and body mass index, both of which are low among Africans, increased progressively with increasing economic level. Conclusions. Transition from a rural to an urbanized lifestyle is accompanied by a rise in the main cardiovascular risk factors; the present data also show that environmental rather than racial factors have a crucial impact on the risk pattern of populations.