Saint Luke's Mid America Heart Institute, and University of Missouri-Kansas City School of Medicine, Kansas City, MO 64111, USA.
Lancet. 2013 Apr 6;381(9873):1211-22. doi: 10.1016/S0140-6736(13)60598-X. Epub 2013 Mar 12.
Atherosclerosis is thought to be a disease of modern human beings and related to contemporary lifestyles. However, its prevalence before the modern era is unknown. We aimed to evaluate preindustrial populations for atherosclerosis.
We obtained whole body CT scans of 137 mummies from four different geographical regions or populations spanning more than 4000 years. Individuals from ancient Egypt, ancient Peru, the Ancestral Puebloans of southwest America, and the Unangan of the Aleutian Islands were imaged. Atherosclerosis was regarded as definite if a calcified plaque was seen in the wall of an artery and probable if calcifications were seen along the expected course of an artery.
Probable or definite atherosclerosis was noted in 47 (34%) of 137 mummies and in all four geographical populations: 29 (38%) of 76 ancient Egyptians, 13 (25%) of 51 ancient Peruvians, two (40%) of five Ancestral Puebloans, and three (60%) of five Unangan hunter gatherers (p=NS). Atherosclerosis was present in the aorta in 28 (20%) mummies, iliac or femoral arteries in 25 (18%), popliteal or tibial arteries in 25 (18%), carotid arteries in 17 (12%), and coronary arteries in six (4%). Of the five vascular beds examined, atherosclerosis was present in one to two beds in 34 (25%) mummies, in three to four beds in 11 (8%), and in all five vascular beds in two (1%). Age at time of death was positively correlated with atherosclerosis (mean age at death was 43 [SD 10] years for mummies with atherosclerosis vs 32 [15] years for those without; p<0·0001) and with the number of arterial beds involved (mean age was 32 [SD 15] years for mummies with no atherosclerosis, 42 [10] years for those with atherosclerosis in one or two beds, and 44 [8] years for those with atherosclerosis in three to five beds; p<0·0001).
Atherosclerosis was common in four preindustrial populations including preagricultural hunter-gatherers. Although commonly assumed to be a modern disease, the presence of atherosclerosis in premodern human beings raises the possibility of a more basic predisposition to the disease.
National Endowment for the Humanities, Paleocardiology Foundation, The National Bank of Egypt, Siemens, and St Luke's Hospital Foundation of Kansas City.
动脉粥样硬化被认为是一种现代人类的疾病，与当代生活方式有关。然而，其在史前时代的流行情况尚不清楚。我们旨在评估工业化前的人群是否存在动脉粥样硬化。
我们对来自四个不同地理区域或人群的 137 具木乃伊进行了全身 CT 扫描，这些人群跨越了 4000 多年。这些个体来自古埃及、古秘鲁、美国西南部的祖先普韦布洛人和阿留申群岛的乌纳安甘人。如果在动脉壁上发现钙化斑块，则将动脉粥样硬化视为明确存在；如果在预期的动脉路径上发现钙化，则将其视为可能存在。
在 137 具木乃伊中有 47 具（34%）存在或可能存在动脉粥样硬化，且这一情况存在于所有四个地理人群中：古埃及的 76 具中有 29 具（38%），古秘鲁的 51 具中有 13 具（25%），美国西南部的祖先普韦布洛人有 5 具中有 2 具（40%），阿留申群岛的乌纳安甘狩猎采集者有 5 具中有 3 具（60%）（p=NS）。28 具木乃伊的主动脉中有动脉粥样硬化（20%），25 具的髂动脉或股动脉中有动脉粥样硬化（18%），25 具的腘动脉或胫动脉中有动脉粥样硬化（18%），17 具的颈动脉中有动脉粥样硬化（12%），6 具的冠状动脉中有动脉粥样硬化（4%）。在检查的五个血管床中，34 具木乃伊（25%）存在一个至两个血管床的动脉粥样硬化，11 具（8%）存在三个至四个血管床的动脉粥样硬化，两具（1%）存在五个血管床的动脉粥样硬化。死亡时的年龄与动脉粥样硬化呈正相关（有动脉粥样硬化的木乃伊的平均死亡年龄为 43 [10]岁，无动脉粥样硬化的木乃伊的平均死亡年龄为 32 [15]岁；p<0·0001），与受累动脉床的数量呈正相关（无动脉粥样硬化的木乃伊的平均死亡年龄为 32 [15]岁，有一个或两个床动脉粥样硬化的木乃伊的平均死亡年龄为 42 [10]岁，有三个至五个床动脉粥样硬化的木乃伊的平均死亡年龄为 44 [8]岁；p<0·0001）。
动脉粥样硬化在包括史前农耕狩猎采集者在内的四个工业化前人群中很常见。尽管动脉粥样硬化通常被认为是一种现代疾病，但在史前人类中存在动脉粥样硬化这一事实提出了这种疾病可能存在更基本的易感性的可能性。
美国国家人文基金会、古心脏学基金会、埃及国民银行、西门子公司和堪萨斯城圣卢克医院基金会。
