AGING, ACCULTURATION, SALT INTAKE, AND HYPERTENSION IN THE KUNA OF PANAMA

The indigenous Kuna who live on islands in the Panamanian Caribbean we re among the first communities described with little age-related rise in blood pressure or hypertension. Our goals in this study were to asc ertain whether isolated island-dwelling Kuna continue to show this pat tern, whether migration to Panama City and its environs changed the pa tterns, and whether the island-dwelling Kuna have maintained their nor mal 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 docum entation of an O+ blood group. In 92 island dwellers, diastolic hypert ension was not identified and blood pressure levels were as low in vol unteers over 60 years of age as in those between 20 and 30 years of ag e. In Panama City, conversely, hypertension prevalence was 10.7% and e xceeded 45% in those over 60 years of age (P < .01), blood pressure le vels were higher in the elderly, and there was a statistically signifi cant positive relationship between age and blood pressure (P < .01). I n Kuna Nega, a Panama City suburb designed to maintain a traditional K una lifestyle but with access to the city, all findings were intermedi ate. Sodium intake and excretion assessed in 50 island dwelling Kuna a veraged 135 +/- 15 mEq/g creatinine per 24 hours, exceeding substantia lly other communities free of hypertension and an age-related rise in blood pressure. Despite partial acculturation, the island-dwelling Kun a Indians are protected from hypertension and thus provide an attracti ve population for examining alternative mechanisms.