November 23, 2009

November 23, 2009 (Orlando, Florida) Checking in on some very old patients with cutting-edge computed tomographic (CT) technology reveals that atherosclerosis might not necessarily be a disease caused by a modern lifestyle. Imaging scans of Egyptian mummies, including some 3500 years old, reveals evidence of atherosclerosis, report researchers.

"There were parts of the cardiovascular system [amazingly] intact," said researcher Dr Randall Thompson (University of Missouri-Kansas City School of Medicine). "We found that on CT scan, atherosclerosis, the disease that we deal so much with, looks surprisingly like it does in our modern-day patients."

Presenting their findings here at the American Heart Association 2009 Scientific Sessions last week, Thompson, along with coinvestigator Dr Sam Wann (Wisconsin Heart Hospital, Milwaukee), said the mummies included in the study all had high social status and many served in the court of the Pharaoh or as priests or priestesses. He added that the group had not expected to see any signs of cardiovascular disease because atherosclerosis is traditionally thought of as a disease caused by an unhealthy fast-food diet, smoking, and lack of exercise. This study, however, suggests the need to look beyond traditional risk factors.

"It looks like people 3000 years ago had the propensity, at least under the circumstances of living in the King's court, to develop this disease," said Wann.

The Mummy and the Skeptical Cardiologist

During a media briefing at the AHA last week, researchers said that the study began when Dr Gregory Thomas (University of California, Irvine), another member of the team, was touring the Museum of Egyptian Antiquities in Cairo last year and came upon Pharaoh Merenptah (c. 1213-1203 BCE). Information on the Pharaoh's nameplate stated that he died at approximately age 60 and was afflicted with atherosclerosis. Skeptical that someone who lived so long ago would have atherosclerosis, American and Egyptian researchers initiated the study to determine if the diagnosis was correct and, if it was, to determine how common atherosclerosis was in a small sample of ancient Egyptians.

Working with Dr Adel Allam (Al Azhar Medical School, Cairo, Egypt) and Dr Michael Miyamoto (University of California, San Diego), as well as with archeologists and mummy experts, in February 2009, the researchers scanned 22 mummies, the oldest of which was 3500 years old. The coronary, aortic, and peripheral vasculature was identified in 16 of the specimens. Definite or probable atherosclerosis was present in nine of the 16 mummies, but among those who were 45 years or older when they died, atherosclerosis was present in 87%.

The most ancient mummy with evidence of atherosclerosis was Lady Rai, a nursemaid to Queen Amrose Nefertari. Lady Rai died in 1530 BCE at an estimated age of 30 to 40 years; she had definite disease in her aortic arch.

At the AHA last week, Thompson and Wann noted that members of the Egyptian upper classes were meat eaters, and their diets would have included cattle, geese, and ducks. Lack of refrigeration, however, meant that many of these meats would have been heavily salted to prevent spoiling, and this might have led some individuals to develop high blood pressure. Although the exact reasons for the calcified build-up in the arteries is unknown, researchers said the results challenge the view that atherosclerosis is a disease of modern humans.

"This disease has been around since the time of Moses; it's as old as the Pyramids," said Thompson.

The report is also published in the November 18, 2009 issue of the Journal of the American Medical Association.