title: Atherosclerosis across 4000 years of human history: the Horus study of four ancient populations.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  National Endowment for the Humanities, Paleocardiology Foundation, The National Bank of Egypt, Siemens, and St Luke's Hospital Foundation of Kansas City.
authors.affiliation: Saint Luke's Mid America Heart Institute, and University of Missouri-Kansas City School of Medicine, Kansas City, MO 64111, USA. rthompson@saint-lukes.org
authors.forename: Randall C
authors.initials: RC
authors.lastname: Thompson
authors.forename: Adel H
authors.initials: AH
authors.lastname: Allam
authors.forename: Guido P
authors.initials: GP
authors.lastname: Lombardi
authors.forename: L Samuel
authors.initials: LS
authors.lastname: Wann
authors.forename: M Linda
authors.initials: ML
authors.lastname: Sutherland
authors.forename: James D
authors.initials: JD
authors.lastname: Sutherland
authors.forename: Muhammad Al-Tohamy
authors.initials: MA
authors.lastname: Soliman
authors.forename: Bruno
authors.initials: B
authors.lastname: Frohlich
authors.forename: David T
authors.initials: DT
authors.lastname: Mininberg
authors.forename: Janet M
authors.initials: JM
authors.lastname: Monge
authors.forename: Clide M
authors.initials: CM
authors.lastname: Vallodolid
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Cox
authors.forename: Gomaa
authors.initials: G
authors.lastname: Abd el-Maksoud
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Badr
authors.forename: Michael I
authors.initials: MI
authors.lastname: Miyamoto
authors.forename: Abd
authors.initials: A
authors.lastname: el-Halim Nur el-Din
authors.forename: Jagat
authors.initials: J
authors.lastname: Narula
authors.forename: Caleb E
authors.initials: CE
authors.lastname: Finch
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000367:Age Factors; D000413:Alaska / Q000208:ethnology; D050197:Atherosclerosis / Q000208:ethnology / Q000266:history*; D004534:Egypt / Q000208:ethnology; D005260:Female; D049668:History, 15th Century; D049669:History, 16th Century; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049690:History, Ancient; D049691:History, Medieval; D006801:Humans; D008297:Male; D009106:Mummies / Q000473:pathology*; D010568:Peru / Q000208:ethnology; D015206:Southwestern United States / Q000208:ethnology; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000208:ethnology / Q000266:history