Hypertension Clinic, Department of Cardiology, Erasme University Hospital.
Cardiac Surgery Department, St Pierre University Hospital.
J Hypertens. 2018 Mar;36(3):520-527. doi: 10.1097/HJH.0000000000001577.
Pygmies living in the Central African rainforest with a traditional hunter-gatherer lifestyle have a low incidence of cardiovascular diseases. Because of progressive loss of traditional habitat and ancestral lands, some Pygmies have migrated to urban areas and adopt specific Bantu lifestyles such as increased salt consumption and a sedentary way of life. We tested the hypothesis that migrant Pygmies could present with hemodynamic and metabolic characteristics different from those of traditional in-situ Pygmies and possibly closer to those of Bantu farmers.
The study included 148 Pygmies (94 traditional and 54 migrants) and 164 Bantus. Peripheral and central hemodynamics, aortic pulse wave velocity (PWV), and augmentation index corrected for heart rate (AIx) were measured, as well as fasting lipid profile. Urinary sodium and potassium excretion was also measured on a morning spot.
Compared to Bantus, Pygmies had lower height (even between men and women, but men were taller than women in the three groups), weight, waist and hip circumference, peripheral and central blood pressure, total, low-density lipoprotein, and high-density lipoprotein cholesterol and apolipoprotein B100 levels, sodium urinary excretion, and lower prevalence of the metabolic syndrome. By contrast, they had a higher waist-to-hip ratio, and higher triglycerides levels, as compared to Bantu farmers. PWV and AIx did not differ between Bantus and Pygmies. Compared to traditional in-situ Pygmies, migrant Pygmies were not taller when adjusted for sex, had lower brachial and central blood pressure, higher PWV (adjusted for mean arterial pressure, BMI, and sex), and higher apolipoprotein B100 levels. In the whole population, multivariable analysis revealed that PWV was independently associated with age, weight, height, mean arterial pressure, total cholesterol, and hip circumference, whereas AIx was independently related to age, sex, height, heart rate, diastolic blood pressure, and group (from Bantu farmers to Pygmies).
Comparisons between Bantus and Pygmies, and between migrant Pygmies and traditional in-situ Pygmies, showed mixed results, with favorable and deleterious hemodynamic and metabolic characteristics in all groups. This could be due to increased contacts between these populations, which blunt the expected differences and because the beneficial effects of the hunter-gatherer subsistence mode of traditional in-situ Pygmies are counterbalanced by unhealthy behavioral habits.
生活在中非热带雨林中、以传统狩猎采集为生的俾格米人患心血管疾病的发病率较低。由于传统栖息地和祖传土地的逐渐丧失,一些俾格米人已经迁移到城市地区,并采用了特定的班图生活方式,例如增加盐的摄入量和久坐的生活方式。我们检验了这样一个假设,即移民俾格米人可能表现出与传统原地俾格米人不同的血液动力学和代谢特征,并且可能更接近班图农民的特征。
该研究纳入了 148 名俾格米人(94 名传统俾格米人和 54 名移民俾格米人)和 164 名班图人。测量了外周和中心血液动力学、主动脉脉搏波速度(PWV)和心率校正后的增强指数(AIx),以及空腹血脂谱。还在早晨采集了尿钠和尿钾排泄量。
与班图人相比,俾格米人的身高较低(即使在男女之间,三组中男性的身高都高于女性),体重、腰围和臀围、外周和中心血压、总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇以及载脂蛋白 B100 水平、尿钠排泄量和代谢综合征的患病率也较低。相比之下,与班图农民相比,他们的腰臀比更高,甘油三酯水平也更高。PWV 和 AIx 在班图人和俾格米人之间没有差异。与传统原地俾格米人相比,移民俾格米人在调整性别后身高较低,肱动脉和中心血压较低,PWV 较高(调整平均动脉压、BMI 和性别后),载脂蛋白 B100 水平也较高。在整个人群中,多变量分析显示,PWV 与年龄、体重、身高、平均动脉压、总胆固醇和臀围独立相关,而 AIx 与年龄、性别、身高、心率、舒张压和组(从班图农民到俾格米人)独立相关。
班图人和俾格米人之间以及移民俾格米人和传统原地俾格米人之间的比较结果喜忧参半,所有组都有有利和不利的血液动力学和代谢特征。这可能是由于这些人群之间的接触增加,从而削弱了预期的差异,并且由于传统原地俾格米人狩猎采集的生存模式的有益影响被不健康的行为习惯所抵消。