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Epidemiological studies in a total highland population, Tukisenta, New Guinea

Cardiovascular disease and relevant clinical, electrocardiographic, radiological and biochemical findings
  • P.F. Sinnett
    Correspondence
    Requests for reprints should be addressed to Professor Peter Sinnett, Department of Human Biology, Faculty of Medicine, University of Papua and New Guinea, P.O. Box 5623, Boroko, Papua New Guinea.
    Footnotes
    Affiliations
    Department of Human Biology, The University of Papua and New Guinea, P.O. Box 5623, Boroko, Papua New Guinea
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  • H.M. Whyte
    Footnotes
    Affiliations
    Department of Human Biology, The University of Papua and New Guinea, P.O. Box 5623, Boroko, Papua New Guinea
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  • Author Footnotes
    ∗ Former Senior Research Fellow, National Heart Foundation of Australia, Department of Clinical Science, The John Curtin School of Medical Research, The Australian National University, Canberra.
    † Professor of Clinical Science, The John Curtin School of Medical Research, The Australian National University, Canberra.
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      Abstract

      A comprehensive survey of cardiovascular disease was carried out on 779 persons over 15 yr of age. Carbohydrate provided more than 90 per cent of caloric intake and the consumption of protein and salt were about 25 and 1 g daily, respectively. Drinking water was soft. The population was lean, physically fit and in good nutritional state. There was no increase with age in mean blood pressure, serum cholesterol (average Math Eq), fasting blood glucose or adiposity. Glucose tolerance was high. The average fasting serum triglyceride level was Math Eq. Serum uric acid levels were not high. Pipe smoking was common. No diabetes or gout were found. There was a low prevalence of diagnosable cardiovascular diseases: hypertension, valvular disease, cardiac decompensation (mostly cor pulmonale) and cerebral and peripheral vascular disease. Ischemic heart diesase was rare if not absent as indicated by resting and post-exercise electrocardiograms. Rates for all codeable ECG items were low except low voltage and T wave changes (commonest in middle aged women). Age-related degenerative changes occurred, such as increasing diameter of the aorta and decreasing creatinine clearance, and the declining ECG voltage with age may be indicative of cardiac disease.
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      References

        • Barnes R
        Incidence of heart disease in a native hospital of Papua.
        Med J Aust. 1961; 2: 540-542
        • Campbell CH
        • Arthur RK
        A study of 2000 admissions to the medical ward of the Port Moresby General Hospital.
        Med J Aust. 1964; 1: 989-992
        • Korner MH
        A sample of heart disease in hospital patients in New Guinea.
        Med J Aust. 1964; 2: 368-370
        • National Heart Foundation of Australia
        Report by Drs Hetzel PS. 1962;
        • National Heart Foundation of Australia
        Report by Grice KG. 1964;
        • National Heart Foundation of Australia
        Report by Studkey D. 1966;
        • National Heart Foundation of Australia
        Report by Galea EG. 1968; (Canberra)
        • Kariks J
        • McGovern VJ
        Heart disease in the Territory of Papua New Guinea: a preliminary report based on a necropsy study.
        Med J Aust. 1967; 1: 176-177
        • Magerey FR
        • Kariks J
        • Arnold L
        Aortic atherosclerosis in Papua and New Guinea compared with Sydney.
        Pathology. 1969; I: 185-191
      1. Sinnett PF, Whyte HM: Epidemiological studies in a total highland population, Tukisenta, New Guinea: environment, culture, health and nutrition. J Human Ecol, 1: 245–278

        • Sinnett PF
        • Blake NM
        • Kirk RL
        • et al.
        Blood serum protein and enzyme groups among Engaspeaking people of the Western Highlands, New Guinea.
        Arch Phys Anthrop Oceania. 1970; V: 236-252
        • Ungerleider HE
        • Gubner R
        Evaluation of heart size measurements.
        Am Heart J. 1942; 24: 494-510
        • Penaloza D
        • Arias-Stella J
        • Sime F
        • et al.
        The heart and pulmonary circulation in children at high altitudes: physiological, anatomical and clinical observations.
        Pediatrics. 1964; 34: 568-582
        • Rose GA
        • Blackburn H
        Cardiovascular Survey Methods.
        WHO Mon Ser No. 56. 1968; (Geneva)
        • Epstein FH
        • Eckoff RD
        The epidemiology of high blood pressure—geographic distributions and etiological factors.
        in: Stamler J Stamler R Pullman TN The Epidemiology of Hypertension. Grune and Stratton, New York1967: 155-166
        • Keith NM
        • Wagener HP
        • Barker NW
        Some different types of cssential hypertension: their course and prognosis.
        Am J Med Sci. 1939; 197: 332-343
        • McDonough JR
        • Hames CG
        • Stulb SC
        • et al.
        Coronary heart disease among negroes and whites in Evans County, Georgia.
        J Chron Dis. 1965; 18: 443-468
        • Davies DF
        • Shock NW
        Age changes in glomerular filtration rate, effective renal plasma flow and tubular excretory capacity in adult males.
        J Clin Invest. 1950; 29: 496-507
        • Master AM
        • Rosenfeld I
        ‘Two-step’ exercise test brought up to date.
        NY State J Med. 1961; 61: 1850-1857
        • Blackburn H
        • Mitchell P
        • Imbimbo B
        The exercise ECG test. At what intervals to record after exercise?.
        Am Heart J. 1964; 67: 186-188
        • Ostrander LD
        • Brandt RL
        • Kjelsberg MO
        • et al.
        Electrocardiographic findings among the adult population of a total natural community, Tecumseh, Michigan.
        Circulation. 1965; 31: 888-898
        • Keys A
        • Aravanis C
        • Blackburn HW
        • et al.
        Epidemiological studies related to coronary heart disease: characteristics of men aged 40–59 in seven countries.
        Acta Med Scand Supp. 1967; 460: 1-392
        • Higgins ITT
        • Kannel WB
        • Dawber TR
        The electrocardiogram in epidemiological studies. Reproducibility, validity, and international comparison.
        Brit J Prev Soc Med. 1965; 19: 53-68
        • Fodor J
        • Miall WE
        • Standard KL
        • et al.
        Myocardial disease in a rural population in Jamaica.
        Bull Wld Hlth Org. 1964; 31: 321-335
      2. Miall WE: Personal communication, 1968

        • Stamler J
        Lectures on Preventive Cardiology.
        in: Grune and Stratton, New York1967: 151
        • Penaloza D
        • Echevarria N
        • Marticorena E
        • et al.
        Early electrocardiographic changes produced by ascending to high altitudes.
        Am Heart J. 1958; 56: 493-500
        • Epstein FH
        • Pollack AA
        • Ostrander LD
        An electrocardiographic survey in Peru.
        Am J Med Sci. 1964; 80: 687-692
        • Kuhn LA
        The effects of Arctic climate and different shelter temperatures on the electrocardiogram.
        Am Heart J. 1956; 51: 387-397
        • Jaffe HL
        • Corday E
        • Master AM
        Evaluation of the precordial leads of the electrocardiogram in obesity.
        Am Heart J. 1948; 36: 911-922
        • Marriott HJ
        Coronary mimicry.
        Ann Intern Med. 1960; 52: 411-421
        • Edeiken J
        Cyclic changes in T waves.
        JAMA. 1962; 180: 460-462
        • Simonson E
        • Alexander H
        • Henschel A
        • et al.
        The effect of meals on the electrocardiogram in normal subjects.
        Am Heart J. 1946; 32: 202-214
        • Sears GA
        • Manning GW
        postprandial T-wave changes.
        Am Heart J. 1958; 56: 591-597
        • Ostrander LD
        • Weinstein BJ
        Electrocardiographic changes after glucose ingestion.
        Circulation. 1964; 30: 67-76
        • Iglesias R
        • Echenique R
        • Gonzalez G
        T wave inversion of the ECG of healthy individuals with vagotonia.
        Aerospace Med. 1969; 40: 318-320
        • Megandantz H
        • Shortsleeve J
        Electrocardiographic abnormalities in patients exhibiting anxiety.
        Am Heart J. 1951; 42: 849-857
        • Mitchell JH
        • Shapiro AP
        The relationship of adrenaline and T wave changes in the anxiety state.
        Am Heart J. 1954; 48: 323-330
        • Simonson E
        • Blackburn H
        • Puchner TC
        • et al.
        Sex differences in the electrocardiogram.
        Circulation. 1960; 22: 598-601
        • Littman D
        Persistence of the juvenile pattern in the precordial leads of healthy adult negroes, with report of electrocardiographic survey on 300 negro and 200 white subjects.
        Am Heart J. 1946; 32: 370-382
        • Brink AJ
        An investigation of factors influencing repolarization in the human heart.
        S African J Clin Sci. 1951; 2: 288-297
        • Grusin H
        Peculiarities of the African's electrocardiogram and the changes observed in serial studies.
        Circulation. 1954; 9: 860-867
        • Wasserburger RH
        Observations on the ‘juvenile pattern’ of adult negro males.
        Am J Med. 1955; 18: 428-437
        • Powell SJ
        Unexplained electrocardiograms in the African.
        Brit Heart J. 1959; 21: 263-268
        • Somers K
        • Rankin AM
        The electrocardiogram in healthy East African (Bantu and Nilotic) men.
        Brit Heart J. 1962; 24: 542-548
        • Srikantia SG
        • Padmavati S
        • Gopalan C
        The electrocardiogram in some Indian population groups.
        Circulation. 1964; 24: 118-123
        • Whyte HM
        Body fat and blood pressure of natives of New Guinea: reflections on essential hypertension.
        Australas Ann Med. 1958; 7: 36-46
        • Barnes R
        Comparisons of blood pressures and blood cholesterol levels of New Guineans and Australians.
        Med J Aust. 1965; 1: 611-617
        • Maddocks I
        • Rovin L
        A New Guinea population in which blood pressure appears to fall as age advances.
        Papua N Guinea Med J. 1965; 8: 17-21
        • Maddocks I
        Blood pressures in Melanesians.
        Med J Aust. 1967; 1: 1123-1126
        • Stanhope JM
        Blood pressure of the Tinam-Aigram people, near Simbai, Madang District.
        Papua N Guinea Med J. 1968; 11: 60-61
        • Dahl LK
        Metabolic aspects of hypertension.
        Ann Rev Med. 1963; 14: 69-98
        • Knudsen KD
        • Dahl LK
        Essential hypertension: inborn error of sodium metabolism?.
        Postgrad Med J. 1966; 42: 148-152
        • Hipsley EH
        • Kirk NE
        Studies of Dietary Intake and The Expenditure of Energy by New Guineans.
        South Pacific Commission Tech Paper No. 147. 1965; (Noumea)
        • Wills PA
        Salt consumption by natives of the Territory of Papua and New Guinea.
        Phillipp J Sci. 1958; 87: 168-188
        • Dawber TR
        • Kannel WB
        • Kagan A
        • et al.
        Environmental factors in hypertension.
        in: Stamler J Stamler R Pullman TN The Epidemiology of Hypertension. Grune and Stratton, New York1967: 255-257
        • Abell LL
        • Levy BB
        • Brodie BB
        • et al.
        A simplified method for the estimation of total cholesterol in serum and demonstration of its specificity.
        J biol Chem. 1952; 195: 357-366
        • Johnson BC
        • Epstein FH
        • Kjelsberg MO
        Distributions and familial studies of blood pressure and serum cholesterol levels in a total community, Tecumseh, Michigan.
        J Chron Dis. 1965; 1: 147-160
        • De Wolfe MS
        • Whyte HM
        Serum cholesterol and lipoproteins in natives of New Guinea and Australians.
        Australas Ann Med. 1958; 7: 47-54
        • Goldrick RB
        • Whyte HM
        A study of blood clotting and serum lipids in natives of New Guinea and Australians.
        Australas Ann Med. 1959; 8: 238-244
        • Goldrick RB
        Fibrinolysis, blood clotting, serum lipids and body build in natives of New Guinea and Australians.
        Australas Ann Med. 1961; 10: 20-28
        • Lloyd MR
        • Goldrick RB
        A simplified method for estimating plasma triglycerides: their stability during cold storage.
        Med J Aust. 1968; 2: 493-496
        • Fredrickson DS
        • Levy RI
        • Lees RS
        Fat transport in lipoproteins—an integrated approach to mechanisms and disorders.
        New Engl J Med. 1967; 276: 148-156
        • Epstein FH
        • Ostrander LD
        • Johnson BC
        • et al.
        Epidemiological studies of cardiovascular disease in a total community, Tecumseh, Michigan.
        Ann Intern Med. 1965; 6: 1170-1187
        • Welborn TA
        • Cumpston GN
        • Cullen KJ
        • et al.
        The prevalence of coronary heart disease and associated factors in an Australian rural community.
        Am J Epid. 1969; 89: 521-536
        • Society of Actuaries
        Build and blood pressure study.
        Chicago. 1959; 1: 16
        • Montoye HJ
        • Epstein FH
        • Kjelsberg MO
        The measurements of body fatness. A study in a total community.
        Am J Nutrit. 1965; 16: 417-427
        • Sinnett PF
        • Solomon A
        Physical fitness in a New Guinea highland population.
        Papua N Guinea Med J. 1968; 11: 56-59
        • Consalazio CF
        • Johnson RE
        • Pecora LJ
        Physiological Measurements of Metabolic Functions in Man.
        McGraw-Hill, New York1963
        • Adam JM
        • Ladell WSS
        Report on field studies on troops of the Commonwealth Division in Korea.
        Scientific Advizer to Army Council, LondonWinter 1951–1952 (Restricted)
        • Ladell WSS
        • Kenny RA
        Quart J Exp Physiol. 1955; 40 (Cited by:): 283-296
        • MacPherson RK
        Tropical fatigue.
        Univ Qld Papers. 1949; 1
        • Astrand I
        Aerobic work capacity in men and women with special reference to age.
        Acta Phys Scand Suppl 169. 1960; 49: 1-92
        • Allen JG
        Aerobic capacity and physiological fitness of Australian men.
        Ergonomics. 1966; 9: 485-494
        • Boehringera and Seohne Gmbh
        Blood Sugar Colorimetric Methods.
        1966 (Germany, Mannhein)
        • Hayner NS
        • Kjelsberg MO
        • Epstein FH
        • et al.
        Carbohydrate tolerance and diabetes in a total community—Tecumseh, Michigan.
        Diabetes. 1965; 14: 413-423
        • Price AVG
        • Tulloch JA
        Diabetes mellitus in Papua and New Guinea.
        Med J Aust. 1966; 2: 645-648
        • Campbell CH
        Diabetes mellitus in the Territory of Papua and New Guinea.
        Med J Aust. 1963; 2: 607-610
        • Hingston RG
        • Price AVG
        Diabetic surveys in Papua.
        Papua N Guinea Med J. 1964; 7: 33-35
        • Crowley LV
        Determination of uric acid. An automated analysis based on a carbonate method.
        Clin Chem. 1964; 10: 838-844
      3. Jeremy R: Personal communication, 1970

        • Mikkelsen WM
        • Dodge HJ
        • Valkenburg H
        The distribution of serum uric acid values in a population unselected as to gout or hyperuricemia. Tecumseh, Michigan, 1959–1960.
        Am J Med. 1965; 39: 242-251
        • Schroeder HA
        Relation between mortality from cardiovascular disease and treated water supplies.
        JAMA. 1960; 172: 1902-1908
        • Morris JN
        • Crawford MD
        • Heady JA
        Hardness of local water supplies and mortality from cardiovascular disease.
        Lancet. 1961; 1: 860-862
        • Ostrander LD
        Serial electrocardiographic findings in a prospective epidemiological study.
        Circulation. 1966; 34: 1069-1080
        • Simonsen E
        • Keys A
        The effect of age and body weight on the electrocardiogram of healthy men.
        Circulation. 1952; 6: 749-761
        • Harlan WR
        • Graybiel A
        • Osborne RK
        Determinants of cardiovascular disease in a young population.
        Am J Cardiol. 1965; 15: 1-12
        • Epstein FH
        The epidemiology of coronary heart disease. A review.
        J Chron Dis. 1965; 18: 735-774
        • Dahl LK
        Effects of chronic salt ingestion—experimental hypertension in the rat: correlation with human hypertension.
        in: Stamler J Stamler R Pullman TN The Epidemiology of Hypertension. Grune and Stratton, New York1967: 218-227
        • Sistrunk WA
        • Miller JC
        • Jones LG
        Carbohydrate changes during storage and cooking of sweet potatoes.
        Food Technol. 1954; 8: 223-226
        • Neel JV
        Diabetes mellitus: a ‘thrifty’ genotype rendered detrimental by ‘progress’?.
        Am J Human Genet. 1962; 14: 353-362
        • Prior IAM
        • Rose BS
        • Harvey HPB
        • et al.
        Hyperuricemia, gout and diabetic abnormality in Polynesian people.
        Lancet. 1966; 1: 333-338