Very Low Prevalence and Incidence of Atrial Fibrillation among Bolivian Forager-Farmers

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. Objectiv...

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Autores principales:	Christopher J. Rowan, Michael A. Eskander, Edmond Seabright, Daniel Eid Rodriguez, Edhitt Cortez Linares, Raul Quispe Gutierrez, Juan Copajira Adrian, Daniel Cummings, Bret Beheim, Kirsten Tolstrup, Abinash Achrekar, Thomas 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, Michael D. Gurven
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2021
Materias:	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/f9ab8548adab4454ac95bd2ef57667da
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spelling	oai:doaj.org-article:f9ab8548adab4454ac95bd2ef57667da2021-12-02T14:11:14ZVery Low Prevalence and Incidence of Atrial Fibrillation among Bolivian Forager-Farmers2214-999610.5334/aogh.3252https://doaj.org/article/f9ab8548adab4454ac95bd2ef57667da2021-02-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/3252https://doaj.org/toc/2214-9996Background: 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.Christopher J. RowanMichael A. EskanderEdmond SeabrightDaniel Eid RodriguezEdhitt Cortez LinaresRaul Quispe GutierrezJuan Copajira AdrianDaniel CummingsBret BeheimKirsten TolstrupAbinash AchrekarThomas KraftDavid E. MichalikMichael I. MiyamotoAdel H. AllamL. Samuel WannJagat NarulaBenjamin C. TrumbleJonathan StieglitzRandall C. ThompsonGregory S. ThomasHillard S. KaplanMichael D. GurvenUbiquity PressarticleInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 87, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Christopher J. Rowan Michael A. Eskander Edmond Seabright Daniel Eid Rodriguez Edhitt Cortez Linares Raul Quispe Gutierrez Juan Copajira Adrian Daniel Cummings Bret Beheim Kirsten Tolstrup Abinash Achrekar Thomas 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 Michael D. Gurven Very Low Prevalence and Incidence of Atrial Fibrillation among Bolivian Forager-Farmers
description	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.
format	article
author	Christopher J. Rowan Michael A. Eskander Edmond Seabright Daniel Eid Rodriguez Edhitt Cortez Linares Raul Quispe Gutierrez Juan Copajira Adrian Daniel Cummings Bret Beheim Kirsten Tolstrup Abinash Achrekar Thomas 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 Michael D. Gurven
author_facet	Christopher J. Rowan Michael A. Eskander Edmond Seabright Daniel Eid Rodriguez Edhitt Cortez Linares Raul Quispe Gutierrez Juan Copajira Adrian Daniel Cummings Bret Beheim Kirsten Tolstrup Abinash Achrekar Thomas 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 Michael D. Gurven
author_sort	Christopher J. Rowan
title	Very Low Prevalence and Incidence of Atrial Fibrillation among Bolivian Forager-Farmers
title_short	Very Low Prevalence and Incidence of Atrial Fibrillation among Bolivian Forager-Farmers
title_full	Very Low Prevalence and Incidence of Atrial Fibrillation among Bolivian Forager-Farmers
title_fullStr	Very Low Prevalence and Incidence of Atrial Fibrillation among Bolivian Forager-Farmers
title_full_unstemmed	Very Low Prevalence and Incidence of Atrial Fibrillation among Bolivian Forager-Farmers
title_sort	very low prevalence and incidence of atrial fibrillation among bolivian forager-farmers
publisher	Ubiquity Press
publishDate	2021
url	https://doaj.org/article/f9ab8548adab4454ac95bd2ef57667da
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Very Low Prevalence and Incidence of Atrial Fibrillation among Bolivian Forager-Farmers

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