Acculturation and cardiovascular reactivity of second-generation Turkish migrants in Germany Stephan Bongard*, Sandra F. Pogge, Halime Arslaner, Sonja Rohrmann, Volker Hodapp Institut fu ¨r Psychologie, Johann Wolfgang Goethe-Universita ¨t, Postfech 11 19 32, Frankfurt/Main D-60054, Germany Received 24 April 2001; accepted 29 November 2001 Abstract Objective: Previous studies have shown that migration and acculturation lead to higher blood pressures and a higher prevalence of cardiovascular diseases. Heightened cardiovascular reactivity is considered as a risk factor for cardiovascular diseases. Therefore, the purpose of the present study was to examine cardiovascular reactivity in young and healthy second- generation Turkish migrants to Germany. Method: Forty-one Turkish and 20 German male students worked on a mental arithmetic task for 6 min and underwent the cold pressor test for 90 s. Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were taken in intervals of 2 min at baseline and during task periods. Stroke volume (SV), cardiac output (CO), preejection period (PEP), and total peripheral resistance (TPR) were registered continuously by impedance cardiography. The Turkish volunteers were divided into weak and advanced acculturated migrants based on self-ratings given in a questionnaire. Results: Advanced acculturated Turkish students showed greater HR and CO increases and greater PEP and TPR decreases to the mental arithmetic task than Germans or weak acculturated Turkish students. No group differences were found for the cold pressor test. Conclusion: Migrants’ acculturation is associated with an enhanced b-adrenergic activation pattern of the sympathetic nervous system that might put them at greater risk with regards to essential hypertension and coronary heart disease. D 2002 Elsevier Science Inc. All rights reserved. Keywords: Acculturation; Emigration and immigration; Cardiovascular diseases; Hemodynamics; Stress Introduction Turkish people constitute the largest ethnic minority in Germany. The first generation of migrants from Turkey was recruited as foreign workers during the 1960s and early 70s. Before they were permitted to immigrate, Turkish workers had to pass a medical screening examination, so it is reasonable to assume that the migrant population was healthier than the average male population of their home country and probably also healthier than the average male population of their host country [1]. The most common illnesses of Turkish workers in Germany, during the first decades, were diseases of the musculoskeletal system and the gastrointestinal tract [2]. However, an increasing pre- valence and incidence for cardiovascular diseases in Turk- ish migrants in Germany has recently been observed. For example, Bilgin et al. [3] reported that coronary heart disease (CHD) mortality in Turkish migrants in Germany is increasing faster than for Turks living in Turkey or for Germans in Germany. Moreover, in patients at the Univer- sity of Giessen Medical School, the mean age for the first diagnosed coronary incidents in the Turkish population was almost 10 years (M = 49.6, S.D. = 6.7) below the mean age of the German patients (M = 58.2, S.D. = 6.7) [3]. Thus, the relatively young age and the dynamics of cardiovas- cular diseases in the Turkish migrant population are increasingly becoming an important issue for Germany’s health care system. Heightened blood pressure is an important risk factor for CHD, and numerous studies have shown that migration and acculturation to a new culture increase blood pressure levels and the prevalence for hypertension and CHD [4–8]. Changes in migrants’ lifestyle and associated biological factors, such as increased salt intake, increased body fat, and decreased exercise, only partly explain this effect [8,9], 0022-3999/02/$ – see front matter D 2002 Elsevier Science Inc. All rights reserved. PII:S0022-3999(02)00347-1 * Corresponding author. Tel.: +49-69-798-22519; fax: +49-69-798- 23363. E-mail address: bongard@psych.uni-frankfurt.de (S. Bongard). Journal of Psychosomatic Research 53 (2002) 795 – 803