mg/dL

Influence of Monastic life on cardiovascular health: The Mount Athos “Agion Oros” expedition
A. Benetos (1), G. Parati (2), P. Salvi (2), A. Achimastos (3), G. Soulis (1), G. Triantafyllou (4), G. Bilo (2), P. Panagopoulos (4), A. Giuliano (2), V. Gollias (4),
T. Comotti (2), V. Achimastos (3), A. Faini (4), S. Gautier (1), M. Doumas (4), Ch. Zamboulis (4).
(1) Université de Nancy-Lorraine, France, (2) Istituto Auxologico Milano, Italy, (3) University of Athens, Greece, (4) University of Thessaloniki, Greece.
Rational: Environmental factors play a major role in the
regulation of BP, development of vascular lesions and metabolic
disorders. Thus, cardiovascular aging can be modulated by
environmental factors and way of life.
Aim: The aim of the “Mount Athos, Agion Oros, Cardiovascular Study” is to evaluate metabolic parameters, BP profiles, LV function and arterial stiffness and thickness in a population of monks
living in Mount Athos as compared with matched community dwelling subjects. We presently show the first results of this study obtained in 94 monks living all in the same Monastery (Vatopedi).
Subjects and Methods: The Mount Athos situated in Halkidiki peninsula in Northern Greece is an independent, exclusively intended to monastic life area regrouping 20 Christian Orthodox
monasteries, in which live around 1000 male monks, respecting a very particular way of life in terms of diet, of circadian rhythms, spirituality and environmental stress. Monks do not eat meat, live in
an isolated low stress environment, spend several hours per day to pray and have circadian rhythms that are very different as compared to other people.
Vatopedi is one of the biggest monasteries in the Athos situated in the north-east part of the peninsula where live approximately 160 monks.
Inclusion criteria
Monks group: Living in Mount Athos for at least 2 consecutive years. The included monks were living either inside the monastery or isolated in peripheral individual structures (skites); They all gave
informed consent to participate in the study.
Control group: male age-matched individuals living in the environing villages, who give informed consent to participate in the study. Investigations in the control group will be performed by our group
during the next months.
Procedures:
Our expedition was performed between 15-21 September 2013. For 6
days the members of the study group lived in the monastery and
performed all the examinations in a specific building inside the monastery.
Our group was installed in 5 different “rooms” in order to perform
simultaneously all exams. For all subjects, the same procedure was
respected. 24h-ABPM apparatus was placed early in the morning .
Subjects underwent then all other procedures starting with questionnaire
and physical exam. Blood was drawn 2-3 hours after the meal. A total of
94 monks participated in the study.
Main criterion: 24h ABPM differences between the 2 groups.
Secondary criteria: differences in aortic stiffness measured by c-fPWV, LV
function, metabolic profiles.
Questionnaire and measurements
of skin AGEs
The preparatives
PulsePen – PWV and PPA
Carotid Echo-Doppler
24h ABPM
Volonteers registration and
distribution of the questionnaires
Echo Cardiography
Lab Tests
Discussions and questions
Physical examination and ECG
Completion
Tables show the mean values
obtained in 94 monks
Demographics and Clinical Parameters
Age
Monastic
Height
Weigth
BMI
Waist circ.
Hip circ
(y)
life (y)
(m)
(kg)
(kg/m2)
(cm)
(cm)
42.0±13.0
14.6±10.3
173.8±8.4
79.1±16.1
26.2±5.2
90.8±13.2
98.6±9.4
SBP
DBP
Heart Rate
(mmHg)
(mmHg)
(b/mn)
117.5±15.7
73.7±10.6
71.1±9.6
Biological parameters
Total
LV diam
LA diam
EDD
ESD
E/A
EF
(mm)
(mm)
(mm)
(mm)
ratio
(%)
33.4±4.0
17.3±2.1
46.8±2.7
28.3±3.1
1.6±0.5
64.5±4.0
24h SBP 24h DBP
120±13
day SBP day DBP
Sept.
122±13
Thikness
LV mass/BSA
EDVol
EDVI
ESVol
ESVI
(mm)
(g/m2)
(ml)
(ml/m2)
(ml)
(ml/m2)
9.1±1.2
81.6±17.3
92.9±14.8
48.1±6.6
33.1±7.3
17.0±3.6
75±7
24h HR
day HR
71±7
4,0
3,5
3,0
2,5
2,0
y = 0,026x + 1,50
R² = 0,227
p<0.001
1,5
110±15
65±9
57±8
10
30
50
70
Age (years)
90
110
Uric Acid
Total prot
(mg/dl)
(mg/dL)
s (mg/dL)
(mg/dL)
(mg/dL)
(g/dL)
190.2±46
115.9±43.5
54.8±12.3
111.2±79.7
82.5±32.7
4.9±1.1
8.2±8.6
Creatinine
Urea
Calcium
γGT
ALTL
ASTL
Iron
(mg/dl)
(mg/dL)
(mg/dL)
(U/L)
(U/L)
(U/L)
(μg/dL)
0.7±0.1
26.9±6.4
9.3±0.8
16.9±10.9
24.1±14.1
21.5±7.5
74.3±28.6
(mg/dL)
Arterial Stiffness and Central BP
PWV
Central SBP
Central PP
PPA*
Aix*
(m/s)
(mmHg)
(mmHg)
(%)
(%)
7.14±1.40
113±17.6
43.5±9.7
33±10
12±17
PPA: Pulse pressure amplification from carotid to brachial artery
Aix: Augmentation Index
11
10
Common Carotid artery geometry
9
8
IMT Left
7
y = 0.052x + 4.97
R² = 0.230
P<0.001
6
5
4
1,0
Glucose
night SBP night DBP night HR
12
4,5
Triglyceride
69±7
PWV vs. Age in the studied monks
C-F PWV (m/sec)
Skin AGEs (arbitrary units)
Skin Advanced Glycation Products
(AGE’s) vs. Age
73±7
HDL Chol.
Cholest
ABPM (mmHg)
Cardiac Echography
LDL Chol.
10
30
50
70
Age (years)
Acknowledgments
We thank the administration of Mount Athos and the direction of the
Vatopedi Monastery for authorizing this study.
We thank all the monks of the Vatopedi monastery for accepting to
participate in the study and helped us to resolve all practical issues
arised.
A special thank to pater-Amvrosios responsible of the medical office of
the monastery for his kindness and efficient participation in the
organization and the realization of the study.
90
110
The « medical » bulding of the
Monastery
IMT Right
(μm)
Diameter Left (mm)
(μm)
Diameter Right (mm)
534±120
6.14±0.50
525±111
6.24±0.56
Conclusions and perspectives
The obtained results in a sample of 94
monks living in strict monastic
conditions, provide the possibility to
assess the influence of a very
particular environment on metabolic
and cardiovascular profiles. These
results will be compared with those of
age-matched males living in the region