Les artères élastiques des Tsimané : Comprendre le mode de vie qui prévient l’athérosclérose

Philadelphia, United States – The arteries of members of an indigenous community in the Bolivian Amazon, dubbed “the healthiest in the world,” show remarkably low rates of coronary atherosclerosis compared to those in other populations. According to a study presented at the 2023 annual congress of the American Heart Association in Philadelphia, these arteries have recently been found to be exceptionally elastic and age more gradually ^[1,2].

The lead researcher, Michael GurvenPhD, director of the Integrative Anthropological Sciences unit at the University of California, Santa Barbara, told Medscape’s Spanish editionthat the study “provides additional evidence that lifestyle modifications can improve arterial health.”

An ancient way of life

The study focused on the Tsimané or Chimane people, an indigenous community in Bolivia that lives by ancestral practices such as slash-and-burn agriculture (mainly plantain, rice, sweet manioc, and corn), river fishing, hunting of neotropical mammals, and foraging for seasonal fruits, honey, and nuts. They are sedentary only 10% of their daily time and follow a diet low in fats and processed carbohydrates.

Over the past decade, numerous studies in this community have documented lower prevalence of high blood pressure, atrial fibrillation, type 2 diabetes, obesity, smoking, sedentary behavior, and, more recently, minimal rates of cognitive dysfunction and dementia ^[3].

In 2017, Michael Gurven led a cross-sectional study showing that Tsimané individuals over 40 had very low coronary calcium scores, which are a marker of coronary atherosclerosis. This result strongly suggests that healthy lifestyle habits are indeed effective in cardiovascular prevention. The mechanisms involved and their evolution with age, however, had to be further explored.

The new research, led by Tian Yu Cao, a student of Micheal Gurven, focused on arterial elasticity, particularly in carotid and femoral arteries, as a measure of potential arterial stiffening and atherosclerosis. The study included approximately 500 adult males and females.

Aging and arterial elasticity

The results revealed that Tsimané arteries are less rigid than those in various urban and sedentary populations previously studied. For example, the elasticity of the small and large arteries of 491 Tsimané individuals (average age: 55.3 years) was 57%-86% higher than that observed in adult men and women in the United States in the Multi-Ethnic Study of Atherosclerosis.

Similarly, carotid-femoral pulse wave velocity, a direct indicator of arterial stiffness, was determined in 89 Tsimané individuals (average age: 53.1 years, 54% women). The average value was 6.34 m/s, about 25% lower than the average of a healthy Brazilian population aged 35-74 years ^[4].

Michael Gurven noted that Tsimané arteries remain elastic for longer than those in other populations. However, at the age of 70, the arteries also begin to harden. “In other words, the Tsimané cannot indefinitely delay arterial aging,” he said.

“The minimal and delayed increase in arterial stiffness associated with age could contribute to the very low levels of coronary atherosclerosis and dementia observed in the Tsimané,” the researchers write.

Pedro Forcada

Pedro Forcada, cardiologist and professor at the University Austral de Buenos Aires, who did not participate in the study, emphasized the impact of epigenetics on atherosclerosis and accelerated vascular aging. He referred to the SUPERNOVA phenomenon in Europe and Japan, where exceptionally low arterial stiffness characterizes people who live to very old ages.

“This indicates that we not only need to understand accelerated vascular aging, but also study protective factors. Lifestyle, according to these recent studies, would play an important role,” he said.

This article was originally published on Medscape in Spanish as “The ‘healthiest arteries in the world’ are also the most elastic.” Edited by Stéphanie Lavaud.