Effects of a Low‐Salt and High‐Potassium Diet on Arterial Stiffness and Left Ventricular Function in Indigenous Papuans

Background A sodium‐restricted diet represents a potential non‐pharmacological strategy for improving blood pressure, arterial stiffness, and left ventricular (LV) diastolic function. We investigated age‐related differences in LV structure and function and the relationship between LV function and central hemodynamics in an indigenous Papuan population, who maintain a traditional lifestyle, including a low‐salt and high‐potassium diet. Methods and Results We measured LV dimensions, transmitral blood flow, and mitral annular tissue velocities through echocardiography and Doppler imaging. Blood pressure and brachial‐ankle pulse wave velocity were measured using an automatic device (Omron). Central blood pressure and wave reflection parameters were estimated via oscillometry (Mobil‐O‐Graph, using European calibrations). A total of 82 native Papuans (median age, 42 years; 38 women; no blood pressure treatment) were enrolled. Age‐related difference in brachial systolic pressure was modest but significant, and brachial‐ankle pulse wave velocity significantly increased with age; however, LV mass index remained unchanged. LV ejection fraction and global longitudinal strain were preserved; mitral A‐wave velocity and average E/e´ increased; and e´ and E/A decreased with age. Brachial‐ankle pulse wave velocity and spot urine Na/K were positively and independently correlated with E/e´. Age and heart rate were inversely associated with E/A. In conclusion, LV systolic function was preserved; however, LV diastolic function decreased with age in Papuans. Moreover, age‐related arterial stiffening, but not wave reflections, was inversely related to LV diastolic function. Conclusions Our results suggest that arterial and LV stiffness may not be altered by sodium restriction. Longitudinal studies are warranted to elucidate the effects of diet on arterial and LV function

Neurodegenerative Diseases in West New-Guinea

Amyotrophic lateral sclerosis (ALS) and parkinsonism-dementia occurred in the highest incidence among primitive Auyu and Jakai people on the southern coastal plain of West New Guinea (Indonesia, Papua) (Gajdusek DC, 1982). After the survey of Gajdusek DC the study is rare about neurodegenerative diseases in Papua. To clarify the prevalence of neurodegenerative diseases in people in West New-Guinea we had the fieldwork survey in 2001-02 and 2006-07. In the survey of people in village of Kepi, Bade and others (population of9700) in 2001-02, 5 patients with parkinsonism and 11 patients with ALS and related diseases and 6 cerebro-vascular diseases were found. In the survey of people in village of Bade and others (population of 8100) in 2007, 6 patients with parkinsonism and 6 patients with ALS and related diseases and 10 cerebro-vascular diseases were found. West New Guinea is the high prevalence area of neurodegenerative diseases still now and cerebro-vascular diseases are increasing. Following-up study should be carried out further

Longitudinal Study for Neuro-degenerative Diseases in Papua, Indonesia

We diagnosed 64 cases of neurological diseases, in the survey during 2001 to 2012, consisting of 1) ALS; 17 cases of probable and definite ALS, 10 cases of possible ALS, including three cases with cognitive impairment (CI), 2) 13 cases of ALS and/or parkinsonism including five cases with CI, 3) 19 cases of parkinsonism including one case with CI, 4) 2 cases of poliomyeloradiculitis, 5)one case of Dopa responsive dystonia. Crude point prevalence rate of pure ALS was estimated at least 73-133/100, 000 people and that of overlap of ALS and parkinsonism was at least 53-98/100, 000 by the survey in Bade in 2007 and in the villages along Edera and Dumut rivers in 2010. Though lower than the prevalence previously reported, the recent prevalence of ALS in this region of Papua is still higher than the global average