Evidence map›Paper›PMID 28320601›Full record

ArticleLancet (London, England)2017

Coronary atherosclerosis in indigenous South American Tsimane: a cross-sectional cohort study.

Hillard Kaplan, Randall C Thompson, Benjamin C Trumble, L Samuel Wann, Adel H Allam, Bret Beheim, Bruno Frohlich, M Linda Sutherland, James D Sutherland, Jonathan Stieglitz and 11 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Lancet (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 165 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
165citing papers in PubMed, 6 pooled it
40.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

165 citing papers in PubMed, 6 syntheses or guidelines pooled it, 334 citations in OpenAlex.

  1. Pooled it
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  4. Pooled it
  5. Preclinical techniques to investigate exercise training in vascular pathophysiology.American journal of physiology. Heart and circulatory physiology · 2021
    Pooled it
  6. Pooled it
  7. Incidence of dementia and mild cognitive impairment in two Indigenous Bolivian cohorts.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Article
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  14. Minimal Evidence of Inflammaging in Naturalistic Chimpanzee Populations.American journal of biological anthropology · 2026
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  18. Review
  19. Oxytocin varies across the life course in a sex-specific way in a human subsistence population.Proceedings of the National Academy of Sciences of the United States of America · 2025
    Article
  20. Article

105 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 20 institutions in 6 countries.

Hillard KaplanDepartment of Anthropology, University of New Mexico, Albuquerque, NM, USA. Electronic address: hkaplan@unm.edu.
Randall C ThompsonSaint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA.
Benjamin C TrumbleSchool of Human Evolution and Social Change, and Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA.
L Samuel WannAscension Healthcare, Milwaukee, WI, USA.
Adel H AllamAl Azhar University, Cairo, Egypt.
Bret BeheimDepartment of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany.
Bruno FrohlichNational Museum of Natural History, Smithsonian Institution, Washington, DC, USA; Dartmouth College, Hanover, NH, USA.
M Linda SutherlandNewport Diagnostic Center, Newport Beach, CA, USA.
James D SutherlandSouth Coast Radiological Medical Group, Laguna Hills, CA, USA.
Jonathan StieglitzInstitute for Advanced Study in Toulouse, Toulouse, France; Department of Anthropology, University of New Mexico, Albuquerque, NM, USA.
Daniel Eid RodriguezDepartment of Medicine, Universidad de San Simón, Cochabamba, Bolivia.
David E MichalikUniversity of California, Irvine School of Medicine, Irvine, CA, USA; Miller Women's and Children's Hospital Long Beach, CA, USA.
Chris J RowanRenown Institute for Heart and Vascular Health, Reno, NV, USA; University of Nevada, Reno, NV, USA.
Guido P LombardiLaboratorio de Paleopatologia, Catedra Pedro Weiss, Universidad Peruana Cayetano Heredia, Lima, Peru.
Ram BediDepartment of Bioengineering, University of Washington, Seattle WA, USA.
Angela R GarciaDepartment of Anthropology University of California Santa Barbara, Santa Barbara, CA, USA.
James K MinWeill Cornell Medical College and the NewYork-Presbyterian Hospital, NY, USA.
Jagat NarulaIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Caleb E FinchUniversity of Southern California Leonard Davis School of Gerontology, Los Angeles, CA, USA; Dornsife College, University of Southern California, Los Angeles, CA, USA.
Michael GurvenDepartment of Anthropology University of California Santa Barbara, Santa Barbara, CA, USA; Long Beach Memorial, Long Beach, CA, USA.
Gregory S ThomasUniversity of California Irvine, Orange, CA, USA.
University of California, Irvine · USAl-Azhar University · EGArizona State University · USAscension · USCardiovascular Medical Group · USDartmouth College · USIcahn School of Medicine at Mount Sinai · USInstitute for Advanced Study in Toulouse · FRLong Beach Memorial Medical Center · USMax Planck Institute for Evolutionary Anthropology · DENewport (United States) · USNewYork–Presbyterian Hospital · USRenown Regional Medical Center · USSaint Luke's Hospital · USUniversidad Peruana Cayetano Heredia · PEUniversity of California, Santa Barbara · USUniversity of New Mexico · USUniversity of San Simón · BOUniversity of Southern California · USUniversity of Washington · US

Funding

Brain atrophy, cognitive impairment and Alzheimer's in low CVD-risk populationRF1AG054442 · NIA · UNIVERSITY OF NEW MEXICO · PI FINCH, CALEB E, GURVEN, MICHAEL DOUGLAS · 2017 to 2020
$8.8M
The Human Life Course and the Biodemography of AgingR01AG024119 · NIA · UNIVERSITY OF CALIFORNIA SANTA BARBARA · PI GURVEN, MICHAEL DOUGLAS, KAPLAN, HILLARD S · 2004 to 2015
$7.4M
The Human Life Course and the Biodemography of AgingR56AG024119 · NIA · UNIVERSITY OF CALIFORNIA SANTA BARBARA · PI GURVEN, MICHAEL DOUGLAS, KAPLAN, HILLARD S · 2009 to 2015
$1.0M
NIA NIH HHS R01 AG024119NIA NIH HHS R56 AG024119NIA NIH HHS RF1 AG054442
6 · The paper itself

Abstract

backgroundConventional coronary artery disease risk factors might potentially explain at least 90% of the attributable risk of coronary artery disease. To better understand the association between the pre-industrial lifestyle and low prevalence of coronary artery disease risk factors, we examined the Tsimane, a Bolivian population living a subsistence lifestyle of hunting, gathering, fishing, and farming with few cardiovascular risk factors, but high infectious inflammatory burden.

methodsWe did a cross-sectional cohort study including all individuals who self-identified as Tsimane and who were aged 40 years or older. Coronary atherosclerosis was assessed by coronary artery calcium (CAC) scoring done with non-contrast CT in Tsimane adults. We assessed the difference between the Tsimane and 6814 participants from the Multi-Ethnic Study of Atherosclerosis (MESA). CAC scores higher than 100 were considered representative of significant atherosclerotic disease. Tsimane blood lipid and inflammatory biomarkers were obtained at the time of scanning, and in some patients, longitudinally.

findingsBetween July 2, 2014, and Sept 10, 2015, 705 individuals, who had data available for analysis, were included in this study. 596 (85%) of 705 Tsimane had no CAC, 89 (13%) had CAC scores of 1-100, and 20 (3%) had CAC scores higher than 100. For individuals older than age 75 years, 31 (65%) Tsimane presented with a CAC score of 0, and only four (8%) had CAC scores of 100 or more, a five-fold lower prevalence than industrialised populations (p≤0·0001 for all age categories of MESA). Mean LDL and HDL cholesterol concentrations were 2·35 mmol/L (91 mg/dL) and 1·0 mmol/L (39·5 mg/dL), respectively; obesity, hypertension, high blood sugar, and regular cigarette smoking were rare. High-sensitivity C-reactive protein was elevated beyond the clinical cutoff of 3·0 mg/dL in 360 (51%) Tsimane participants.

interpretationDespite a high infectious inflammatory burden, the Tsimane, a forager-horticulturalist population of the Bolivian Amazon with few coronary artery disease risk factors, have the lowest reported levels of coronary artery disease of any population recorded to date. These findings suggest that coronary atherosclerosis can be avoided in most people by achieving a lifetime with very low LDL, low blood pressure, low glucose, normal body-mass index, no smoking, and plenty of physical activity. The relative contributions of each are still to be determined.

fundingNational Institute on Aging, National Institutes of Health; St Luke's Hospital of Kansas City; and Paleocardiology Foundation.

Indexed as

AdultAgedAged, 80 and overAge DistributionAnthropometryAtherosclerosisBoliviaCohort StudiesCoronary AngiographyCoronary Artery DiseaseCross-Sectional StudiesFemaleHumansInflammation MediatorsLife StyleLipidsInflammation MediatorsLipids

Identifiers

PMID28320601
PMCPMC6028773
OpenAlexW2595593911

What OpenQuestion holds

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LicenceTDM
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.