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

Author

Listed:
  • 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

    (Unknown)

  • Michael D. Gurven

    (Unknown)

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.

Suggested Citation

  • 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, 2021. "Very low prevalence and incidence of atrial fibrillation among Bolivian forager-farmers," Post-Print hal-03167788, HAL.
  • Handle: RePEc:hal:journl:hal-03167788
    DOI: 10.5334/aogh.3252
    Note: View the original document on HAL open archive server: https://hal.science/hal-03167788
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    References listed on IDEAS

    as
    1. Michael Gurven & Adrian V Jaeggi & Hillard Kaplan & Daniel Cummings, 2013. "Physical Activity and Modernization among Bolivian Amerindians," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-13, January.
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