The Tsimane, a forager-horticulturalist population indigenous to the Bolivian Amazon, have the lowest reported levels of vascular ageing for any population studied, with rates of coronary atherosclerosis five times lower than in the U.S., according to a study presented March 16 during ACC.17 in Washington, DC, and simultaneously published in The Lancet.

In the cross-sectional cohort study, researchers visited 85 Tsimane villages between 2014 and 2015 and took CT scans of the hearts of roughly 700 adults between the ages of 40 and 94 to measure the extent of the hardening of the coronary arteries among other metrics.

Based on the CT scans, 85 percent of the Tsimane people had no risk of heart disease, 13 percent had low risk and only three percent had moderate or high risk. These findings continued into old age, where nearly two-thirds of those over 75 years old had almost no risk of heart disease and only eight percent had moderate or high risk. By comparison, a U.S. study of 6,814 people aged 45 to 84 found that only 14 percent of Americans had a CT scan that suggested no risk of heart disease and 50 percent had a moderate or high risk.

"These findings are very significant," says Randall Thompson, MD, FACC, from Saint Luke's Mid America Heart Institute cardiologist, who presented the results of the study at ACC.17. "Put another way, the arteries of the Tsimane are 25-30 years younger than the arteries of sedentary urbanites. The data also show that the Tsimane arteries are aging at a much slower rate."

Research suggests that the loss of subsistence diets and lifestyles in contemporary society could join age, smoking, high cholesterol, high blood pressure, physical inactivity, obesity and diabetes as a risk factor for heart disease. In the Tsimane population, heart rate, blood pressure, cholesterol, and blood glucose were also low, possibly as a result of their lifestyle. The Tsimane spend only 10 percent of their daytime being inactive, instead participating in hunting, gathering, fishing and farming. Their diet is also very low in fat and consists largely of non-processed carbohydrates.

"In cities, we can drive to a fast food restaurant and pick up 2,000 calories without getting out of our car," said co-author Ben Trumble, MD. "For the vast majority of human existence we would have needed to hunt or fish to obtain meat – sedentary urban life is a completely novel human environment, and this study helps show that heart disease may be a side effect of our new lifestyle and environment."

Moving forward, the authors encourage incorporating Tsimane-inspired lifestyle choices where possible. "This study shows that prevention really works," said Gregory S. Thomas, MD, FACC. "Most of the Tsimane are able to live their entire life without developing any coronary atherosclerosis. This has never been seen in any prior research. While difficult to achieve in the industrialized world, we can adopt some aspects of their lifestyle to forestall a condition we thought would eventually affect almost all of us."

Keywords: ACC17, ACC Annual Scientific Session, Aged, 80 and over, Biomarkers, Calcium, Cholesterol, LDL, Coronary Artery Disease, Exercise, Inflammation, Life Style, Middle Aged, Prevalence, Risk Factors, Tomography, X-Ray Computed, Triglycerides

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