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SAN FRANCISCO—Heart disease is a serial killer that’s been stalking mankind for 4,000 years, according to research presented March 10 at the American College of Cardiology (ACC) scientific session and published concurrently online in The Lancet. CT imaging showed evidence of atherosclerosis in 35 percent of mummies from four ancient civilizations. The myth-busting Horus study suggests atherosclerosis may not be linked to modern lifestyles and diet.
The study expands on previous CT imaging of Egyptian mummies, which had detected atherosclerosis. However, skeptics suggested atherosclerosis in ancient Egyptians may be linked to the diet and high socioeconomic status of mummified Egyptians. So the researchers cast a wider net, securing more mummies for imaging and recruiting additional experts.
In order to determine the existence of atherosclerosis in other ancient cultures, Randall C. Thompson, MD, from Saint Luke’s Mid America Heart Institute in Kansas City, Mo., and colleagues reviewed CT scans of 137 mummies from four ancient populations spanning 4,000 years. The subjects included 76 mummies from ancient Egypt, 51 from ancient Peru, five from the Ancestral Puebloans of the southwest U.S. and five from the Unangan of the Aleutian Islands. Mummies were selected for imaging based on their state of preservation and the likelihood of adult age.
Seven cardiovascular imagers interpreted the CT scans and determined whether mummies had calcification in the wall of a clearly identifiable artery, which was considered diagnostic of atherosclerosis, or calcification along the expected course of an artery, or probable atherosclerosis. Five vascular regions were identified: the carotid, coronary, aortic, iliac or femoral, and popliteal or tibial vascular beds.
Reviewers identified definite atherosclerosis in 25 mummies and probable atherosclerosis in 22 mummies. A total of 38 percent of ancient Egyptians showed atherosclerosis, 25 percent of Peruvians, 40 percent of Ancestral Puebloans and 60 percent of Unangan.
Mummies with atherosclerosis tended to be estimated as older at the time of death at 43 years while the average estimated age of all mummies was 36 years. Logistic regression indicated age was associated with increased odds of atherosclerotic severity, at approximately 69 percent per decade of life.
Atherosclerosis seemed to affect both sexes equally. Thirty-nine percent of mummies identified as females had atherosclerosis and 39 percent of those identified as males also had atherosclerosis.
“Our findings greatly increase the number of ancient people known to have atherosclerosis and show for the first time that the disease was common in several ancient cultures with varying lifestyles, across a wide geographical distance and over a very long span of human history,” wrote Randall et al. “These findings suggest our understanding of the causative factors is incomplete, and that atherosclerosis could be inherent to the process of aging.” Another possibility is that modern physicians do not understand risk factors for atherosclerosis as well as they believe, Randall suggested.
Several ancient lifestyle factors may have increased risk for atherosclerosis among ancient populations, including persistent smoke inhalation from cooking fires and a high level of chronic infection leading to inflammation.
Horus represents a work in progress, according to Samuel L. Waan, MD, director of cardiology at the Wisconsin Heart Hospital in Milwaukee.
“We plan to stay hot on the trail of this killer,” said Thompson. This includes subjecting the mummies to other modern techniques and recruiting subjects from additional ancient populations.
The Horus study, named for the Egyptian deity, was funded by a grant from the National Endowment for the Humanities, the National Bank of Egypt, Siemens Healthcare and the St. Luke’s Hospital Foundation.