Very low prevalence and incidence of atrial fibrillation among Bolivian forager-farmers

Christophe J. Rowan, Michael A. Eskander, Edmond Seabright, Daniel Eid Rodriguez, Edhitt Cortez Linares, Raul Quispe Gutierrez, Juan Copajira Adrian, Daniel Cummings, Bret A. Beheim, Tolstrup Kirsten, Achrekar Abinash, Thomas S. Kraft, David E. Michalik, Michael I. Miyamoto, Adel H. Allam, L. Samuel Wann, Jagat Narula, Benjamin C. Trumble, Jonathan Stieglitz, Randall C. Thompson, Gregory S. Thomas, Hillard S. Kaplan and Michael D. Gurven
Additional contact information
Christophe J. Rowan: Unknown
Michael A. Eskander: Unknown
Edmond Seabright: Unknown
Daniel Eid Rodriguez: Unknown
Edhitt Cortez Linares: Unknown
Raul Quispe Gutierrez: Unknown
Juan Copajira Adrian: Unknown
Daniel Cummings: Unknown
Bret A. Beheim: Unknown
Tolstrup Kirsten: Unknown
Achrekar Abinash: Unknown
Thomas S. Kraft: Unknown
David E. Michalik: Unknown
Michael I. Miyamoto: Unknown
Adel H. Allam: Unknown
L. Samuel Wann: Unknown
Jagat Narula: Unknown
Benjamin C. Trumble: Unknown
Jonathan Stieglitz: IAST - Institute for Advanced Study in Toulouse
Randall C. Thompson: Unknown
Gregory S. Thomas: Unknown
Hillard S. Kaplan: IAST - Institute for Advanced Study in Toulouse
Michael D. Gurven: Unknown

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Abstract: Background: Atrial fibrillation is the most common arrhythmia in post-industrialized populations. Older age, hypertension, obesity, chronic inflammation, and diabetes are significant atrial fibrillation risk factors, suggesting that modern urban environments may promote atrial fibrillation. Objective: Here we assess atrial fibrillation prevalence and incidence among tropical horticulturalists of the Bolivian Amazon with high levels of physical activity, a lean diet, and minimal coronary atherosclerosis, but also high infectious disease burden and associated inflammation. Methods: Between 2005–2019, 1314 Tsimane aged 40–94 years (52% female) and 534 Moseten Amerindians aged 40–89 years (50% female) underwent resting 12-lead electrocardiograms to assess atrial fibrillation prevalence. For atrial fibrillation incidence assessment, 1059 (81% of original sample) Tsimane and 310 Moseten (58%) underwent additional ECGs (mean time to follow up 7.0, 1.8 years, respectively). Findings:Only one (male) of 1314 Tsimane (0.076%) and one (male) of 534 Moseten (0.187%) demonstrated atrial fibrillation at baseline. There was one new (female) Tsimane case in 7395 risk years for the 1059 participants with >1 ECG (incidence rate = 0.14 per 1,000 risk years). No new cases were detected among Moseten, based on 542 risk years. Conclusion: Tsimane and Moseten show the lowest levels of atrial fibrillation ever reported, 1/20 to ~1/6 of rates in high-income countries. These findings provide additional evidence that a subsistence lifestyle with high levels of physical activity, and a diet low in processed carbohydrates and fat is cardioprotective, despite frequent infection-induced inflammation. Findings suggest that atrial fibrillation is a modifiable lifestyle disease rather than an inevitable feature of cardiovascular aging.

Date: 2021-02
Note: View the original document on HAL open archive server: https://hal.science/hal-03167788v1
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Published in Annals of Global Health, 2021, vol. 87 (n° 1), pp.18-33. ⟨10.5334/aogh.3252⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-03167788

DOI: 10.5334/aogh.3252

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