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To investigate the relationship of dietary factors to cardiovascular diseases, we conducted a study of 234 middle-aged Japanese men and women in Okinawa (JJ), and 160 Japanese immigrants of similar age, originally from Okinawa, in Brazil (JB). JB showed double the prevalence (%) of ST-T changes in the electrocardiogram (ECG) (JJ: M3.4, F4.4, JB: M8.3, F10.1) and of hypertension (HT) (JJ: M15.9, F18.4; JB: M32.8, F36.4, p < 0.05) when this was assessed on BP> 160195 and/or the taking of antihypertensive medication; however the mean level of blood pressure did not differ. A gradient in the rate of HT in men and of ECG ST-T changes in both sexes was observed from JJ to JB of first-generation and to JB of second-generation. JB had much higher body mass index (kg/m2) (JJ: M24.8 ± 0.3, F24.8 ± 0.4; JB:M26.2 ± 0.4, F26.5±0.4, p < 0.01) in both sexes, and an 8-fold higher rate of oral contraceptive usage (p < 0.001). Total cholesterol level showed no significant difference between JJ and JB. 24-hour urinary taurine excretion in both sexes and plasma phospholipid n-3 fatty acid level in men were significantly higher in JJ than in JB. The dietary pattern in Japanese immigrants in Brazil, characterized by low fish and large meat intake, is possibly responsible for the higher risk of HT and ECG ST-T changes, indicating the importance of dietary rather than genetic factors. (Hypertens Res 1992;15: 45-55)

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