Lifestyle Incongruity and Adult Blood Pressure in Western Samoa

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Abstract
The effects of lifestyle incongruity on blood pressure were tested in a cross-sectional study of 711 modernizing adult men and women, ages 25 to 64 years, residing in nine villages throughout Western Samoa. Lifestyle incongruity (LI) was conceptualized as the mismatch between a 21-item material possessions and lifestyle scale and an eight-part occupational rank score. LI was measured by the arithmetic difference between the standardized distributions of lifestyle and occupation. Blood pressure (BP) was measured three times in the seated position, averaged and adjusted for body mass. Sex-stratified analyses were performed and adjusted BP was regressed on LI, age, and socioeconomic rank. In men systolic BP was associated (p < .01) with incongruity between material way of life and occupation. Men with higher occupation scores than lifestyle scores had significantly higher systolic BP. This association was stronger and significant for both systolic and diastolic BP among young (<40 years) men and all men from the more economically developed island. On the other hand, among older women diastolic BP was significantly (p < .01) higher among those whose material lifestyles exceeded their occupational class. The results in men, especially the young group, suggest two explanations: 1) financial demands from the extended family on young men with better paying jobs may reduce material consumption and produce psychosocial stress; 2) upward socioeconomic mobility marked by good jobs but a lag in material lifestyle may represent work stress. The results in older women support the suggestion of earlier studies that excess material consumption for enhancement of social prestige (living beyond ones' means) leads to stress and elevations in BP.