Skip to main content
PMC home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1996 Oct;50(5):497–504. doi: 10.1136/jech.50.5.497

Incidence of hypertension and non-insulin dependent diabetes mellitus and associated risk factors in a rapidly developing Caribbean community: the St James survey, Trinidad.

G J Miller 1, G H Maude 1, G L Beckles 1
PMCID: PMC1060339  PMID: 8944854

Abstract

OBJECTIVE: To compare the incidence rates of hypertension and non-insulin dependent diabetes mellitus in relation to ethnicity and other characteristics in a rapidly developing community. DESIGN: Prospective surveillance of a total community for five years. SUBJECTS: Cohort of 2491 men and women aged 35 to 69 years (79% response), of African, Indian and "other' (mainly Afro-European) descent. RESULTS: During surveillance, secular increases occurred in fasting blood glucose concentrations in both sexes and in body mass index (BMI) in men, with apparent secular reductions in systolic blood pressure in both sexes. Incidence rates of hypertension did not differ significantly with ethnicity, ranging between 33 and 41 per 1000 person-years in men and between 27 and 32 per 1000 person-years in women. In men, the incidence of diabetes (per 1000 person-years) in Indians (24) was significantly higher than in Africans (13) and others (11). In women, the diabetic incidence was similar to that for men in Indians (23) and Africans (14), but in others was twice that in men (21). In both sexes, weight gain was an important risk factor for hypertension, whereas risk of diabetes increased with BMI at baseline. The increased risk of diabetes in Indians among men was independent of baseline BMI and blood glucose. CONCLUSION: Apart from the increased risk of diabetes in Indians, ethnicity had no significant influence on incidence rates of hypertension and diabetes in Trinidad. Secular increases in blood glucose in both sexes and in BMI in men probably contributed to the concurrent increase in mortality from coronary heart disease in this community.

Full text

PDF
498

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adverse reactions to bendrofluazide and propranolol for the treatment of mild hypertension. Report of Medical Research Council Working Party on Mild to Moderate Hypertension. Lancet. 1981 Sep 12;2(8246):539–543. [PubMed] [Google Scholar]
  2. Apostolides A. Y., Cutter G., Daugherty S. A., Detels R., Kraus J., Wassertheil-Smoller S., Ware J. Three-year incidence of hypertension in thirteen U.S. communities. On behalf of the Hypertension Detection and Follow-up Program cooperative group. Prev Med. 1982 Sep;11(5):487–499. doi: 10.1016/0091-7435(82)90063-9. [DOI] [PubMed] [Google Scholar]
  3. Ashley F. W., Jr, Kannel W. B. Relation of weight change to changes in atherogenic traits: the Framingham Study. J Chronic Dis. 1974 Mar;27(3):103–114. doi: 10.1016/0021-9681(74)90079-4. [DOI] [PubMed] [Google Scholar]
  4. Barret-Connor E., Criqui M. H., Klauber M. R., Holdbrook M. Diabetes and hypertension in a community of older adults. Am J Epidemiol. 1981 Mar;113(3):276–284. doi: 10.1093/oxfordjournals.aje.a113097. [DOI] [PubMed] [Google Scholar]
  5. Blair D., Habicht J. P., Sims E. A., Sylwester D., Abraham S. Evidence for an increased risk for hypertension with centrally located body fat and the effect of race and sex on this risk. Am J Epidemiol. 1984 Apr;119(4):526–540. doi: 10.1093/oxfordjournals.aje.a113770. [DOI] [PubMed] [Google Scholar]
  6. Cassano P. A., Rosner B., Vokonas P. S., Weiss S. T. Obesity and body fat distribution in relation to the incidence of non-insulin-dependent diabetes mellitus. A prospective cohort study of men in the normative aging study. Am J Epidemiol. 1992 Dec 15;136(12):1474–1486. doi: 10.1093/oxfordjournals.aje.a116468. [DOI] [PubMed] [Google Scholar]
  7. Chaturvedi N., McKeigue P. M., Marmot M. G. Resting and ambulatory blood pressure differences in Afro-Caribbeans and Europeans. Hypertension. 1993 Jul;22(1):90–96. doi: 10.1161/01.hyp.22.1.90. [DOI] [PubMed] [Google Scholar]
  8. Chiang B. N., Perlman L. V., Epstein F. H. Overweight and hypertension. A review. Circulation. 1969 Mar;39(3):403–421. doi: 10.1161/01.cir.39.3.403. [DOI] [PubMed] [Google Scholar]
  9. Collins R., Peto R., MacMahon S., Hebert P., Fiebach N. H., Eberlein K. A., Godwin J., Qizilbash N., Taylor J. O., Hennekens C. H. Blood pressure, stroke, and coronary heart disease. Part 2, Short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context. Lancet. 1990 Apr 7;335(8693):827–838. doi: 10.1016/0140-6736(90)90944-z. [DOI] [PubMed] [Google Scholar]
  10. Cruickshank J. K., Jackson S. H., Beevers D. G., Bannan L. T., Beevers M., Stewart V. L. Similarity of blood pressure in blacks, whites and Asians in England: the Birmingham Factory Study. J Hypertens. 1985 Aug;3(4):365–371. doi: 10.1097/00004872-198508000-00009. [DOI] [PubMed] [Google Scholar]
  11. Dischinger P. C., Apostolides A. Y., Entwisle G., Hebel J. R. Hypertension incidence in an inner-city black population. J Chronic Dis. 1981;34(8):405–413. doi: 10.1016/0021-9681(81)90039-4. [DOI] [PubMed] [Google Scholar]
  12. Feldman R., Sender A. J., Siegelaub A. B. Difference in diabetic and nondiabetic fat distribution patterns by skinfold measurements. Diabetes. 1969 Jul;18(7):478–486. doi: 10.2337/diab.18.7.478. [DOI] [PubMed] [Google Scholar]
  13. Feskens E. J., Kromhout D. Cardiovascular risk factors and the 25-year incidence of diabetes mellitus in middle-aged men. The Zutphen Study. Am J Epidemiol. 1989 Dec;130(6):1101–1108. doi: 10.1093/oxfordjournals.aje.a115437. [DOI] [PubMed] [Google Scholar]
  14. Florey C. V. Blood sugar and serum insulin levels in Jamaica, West Indies. Adv Metab Disord. 1978;9:65–91. doi: 10.1016/b978-0-12-027309-6.50010-0. [DOI] [PubMed] [Google Scholar]
  15. Florey C. du V., Ashcroft M. T., Miller G. J. Blood pressure levels of Guyanese adults of African and Indian origin. Am J Epidemiol. 1971 Nov;94(5):419–424. doi: 10.1093/oxfordjournals.aje.a121338. [DOI] [PubMed] [Google Scholar]
  16. Garcia M. J., McNamara P. M., Gordon T., Kannel W. B. Morbidity and mortality in diabetics in the Framingham population. Sixteen year follow-up study. Diabetes. 1974 Feb;23(2):105–111. doi: 10.2337/diab.23.2.105. [DOI] [PubMed] [Google Scholar]
  17. JOHNSON B. C., REMINGTON R. D. A sampling study of blood pressure levels in white and Negro residents of Nassau, Bahamas. J Chronic Dis. 1961 Jan;13:39–51. doi: 10.1016/0021-9681(61)90043-1. [DOI] [PubMed] [Google Scholar]
  18. Jarrett R. J., Keen H., McCartney M., Fuller J. H., Hamilton P. J., Reid D. D., Rose G. Glucose tolerance and blood pressure in two population samples: their relation to diabetes mellitus and hypertension. Int J Epidemiol. 1978 Mar;7(1):15–24. doi: 10.1093/ije/7.1.15. [DOI] [PubMed] [Google Scholar]
  19. Keil J. E., Tyroler H. A., Sandifer S. H., Boyle E., Jr Hypertension: effects of social class and racial admixture: the results of a cohort study in the black population of Charleston, South Carolina. Am J Public Health. 1977 Jul;67(7):634–639. doi: 10.2105/ajph.67.7.634. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. MCDONOUGH J. R., GARRISON G. E., HAMES C. G. BLOOD PRESSURE AND HYPERTENSIVE DISEASE AMONG NEGROES AND WHITES; A STUDY IN EVANS COUNTY, GEORGIA. Ann Intern Med. 1964 Aug;61:208–228. doi: 10.7326/0003-4819-61-2-208. [DOI] [PubMed] [Google Scholar]
  21. McKeigue P. M., Marmot M. G., Syndercombe Court Y. D., Cottier D. E., Rahman S., Riemersma R. A. Diabetes, hyperinsulinaemia, and coronary risk factors in Bangladeshis in east London. Br Heart J. 1988 Nov;60(5):390–396. doi: 10.1136/hrt.60.5.390. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Medalie J. H., Papier C. M., Goldbourt U., Herman J. B. Major factors in the development of diabetes mellitus in 10,000 men. Arch Intern Med. 1975 Jun;135(6):811–817. [PubMed] [Google Scholar]
  23. Medalie J. H., Papier C., Herman J. B., Goldbourt U., Tamir S., Neufeld H. N., Riss E. Diabetes mellitus among 10,000 adult men. I. Five-year incidence and associated variables. Isr J Med Sci. 1974 Jul;10(7):681–697. [PubMed] [Google Scholar]
  24. Miller G. J., Beckles G. L., Maude G. H., Carson D. C., Alexis S. D., Price S. G., Byam N. T. Ethnicity and other characteristics predictive of coronary heart disease in a developing community: principal results of the St James Survey, Trinidad. Int J Epidemiol. 1989 Dec;18(4):808–817. doi: 10.1093/ije/18.4.808. [DOI] [PubMed] [Google Scholar]
  25. Miller G. J., Kotecha S., Wilkinson W. H., Wilkes H., Stirling Y., Sanders T. A., Broadhurst A., Allison J., Meade T. W. Dietary and other characteristics relevant for coronary heart disease in men of Indian, West Indian and European descent in London. Atherosclerosis. 1988 Mar;70(1-2):63–72. doi: 10.1016/0021-9150(88)90100-1. [DOI] [PubMed] [Google Scholar]
  26. Noppa H. Body weight change in relation to incidence of ischemic heart disease and change in risk factors for ischemic heart disease. Am J Epidemiol. 1980 Jun;111(6):693–704. doi: 10.1093/oxfordjournals.aje.a112947. [DOI] [PubMed] [Google Scholar]
  27. Peiris A. N., Sothmann M. S., Hoffmann R. G., Hennes M. I., Wilson C. R., Gustafson A. B., Kissebah A. H. Adiposity, fat distribution, and cardiovascular risk. Ann Intern Med. 1989 Jun 1;110(11):867–872. doi: 10.7326/0003-4819-110-11-867. [DOI] [PubMed] [Google Scholar]
  28. Perry I. J., Wannamethee S. G., Walker M. K., Thomson A. G., Whincup P. H., Shaper A. G. Prospective study of risk factors for development of non-insulin dependent diabetes in middle aged British men. BMJ. 1995 Mar 4;310(6979):560–564. doi: 10.1136/bmj.310.6979.560. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Pollare T., Lithell H., Selinus I., Berne C. Sensitivity to insulin during treatment with atenolol and metoprolol: a randomised, double blind study of effects on carbohydrate and lipoprotein metabolism in hypertensive patients. BMJ. 1989 Apr 29;298(6681):1152–1157. doi: 10.1136/bmj.298.6681.1152. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Rimm E. B., Chan J., Stampfer M. J., Colditz G. A., Willett W. C. Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. BMJ. 1995 Mar 4;310(6979):555–559. doi: 10.1136/bmj.310.6979.555. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Stamler J., Rhomberg P., Schoenberger J. A., Shekelle R. B., Dyer A., Shekelle S., Stamler R., Wannamaker J. Multivariate analysis of the relationship of seven variables to blood pressure: findings of the Chicago Heart Association Detection Project in Industry, 1967-1972. J Chronic Dis. 1975 Nov;28(10):527–548. doi: 10.1016/0021-9681(75)90060-0. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES