Key result
Traditional African lifestyle is associated with a low ~1% prevalence of myocardial infarction.
Why the study?
To test the inflammatory origin of cardiovascular disease as opposed to its origin in western lifestyle by assessing cardiovascular risk factors and disease prevalence in an inflammation-prone African population.
Does a traditional African lifestyle with a high infectious load without western lifestyle factors result in lower cardiovascular disease prevalence in adults over 50?
Cross-Sectional (n=924)
No
Does a traditional African lifestyle with a high infectious load without western lifestyle factors result in lower cardiovascular disease prevalence in adults over 50?
Inflammatory processes alone do not suffice to cause cardiovascular disease; a western lifestyle appears to be a prerequisite for its development.
Low CVD prevalence in high-infection rural Africans should not change practice; leaves open whether western lifestyle is required for atherosclerosis.
BACKGROUND: To test the inflammatory origin of cardiovascular disease, as opposed to its origin in western lifestyle. Population-based assessment of the prevalences of cardiovascular risk factors and cardiovascular disease in an inflammation-prone African population, including electrocardiography and ankle-arm index measurement. Comparison with known prevalences in American and European societies. METHODOLOGY/PRINCIPAL FINDINGS: Traditional population in rural Ghana, characterised by adverse environmental conditions and a high infectious load. Population-based sample of 924 individuals aged 50 years and older. Median values for cardiovascular risk factors, including waist circumference, BMI, blood pressure, and markers of glucose and lipid metabolism and inflammation. Prevalence of myocardial infarction detected by electrocardiography and prevalence of peripheral arterial disease detected by ankle-arm index. When compared to western societies, we found the Ghanaians to have more proinflammatory profiles and less cardiovascular risk factors, including obesity, dysglycaemia, dyslipidaemia, and hypertension. Prevalences of cardiovascular disease were also lower. Definite myocardial infarction was present in 1.2% (95%CI: 0.6 to 2.4%). Peripheral arterial disease was present in 2.8% (95%CI: 1.9 to 4.1%). CONCLUSIONS/SIGNIFICANCE: Taken together, our data indicate that for the pathogenesis of cardiovascular disease inflammatory processes alone do not suffice and additional factors, probably lifestyle-related, are mandatory.
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Koopman et al. (2012) conducted a cross-sectional in Cardiovascular risk factors and disease (n=924). Traditional rural African lifestyle with high infectious load vs. Western societies (American and European reference populations) was evaluated on Prevalence of definite myocardial infarction detected by electrocardiography (95% CI 0.6-2.4). A traditional African lifestyle with high infectious load was associated with a low prevalence of myocardial infarction (1.2%) and peripheral arterial disease (2.8%) compared to western societies.
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