Why would a third of the mummies of the ancient cultures of Egypt, Peru, the American Southwest and the Aleutian Islands have atherosclerosis when their mean age of death was 36 years? Why would a 50 year old female hunter gather living a subsistence life style consuming a marine based diet in the Aleutian Islands have CAD? Is atherosclerosis a fundamental component of aging analogous to presbyopia or wrinkles? Or is it environmental secondary to lifestyle and choices humans make? Are we genetically hard wired to develop atherosclerosis or can we prevent it? If we can prevent it, have we characterised all key risk factors for atherosclerosis? Is the present state of medical knowledge such that we can measure all the physiologic factors potentially causal in the development of atherosclerosis?
These questions will be explored in a discussion of the results of the Horus mummy study of 137 mummies who lived over the last 4,000 years demonstrating that atherosclerosis was a common at least subclinical disease. Infection was a common, likely daily, experience in these ancient cultures without modern hygiene, knowledge of germ theory or antibiotics. A comprehensive autopsy of an Egyptian teenage boy named Nakht who lived along the Nile 3100 years ago demonstrated that he was infected with four different parasites causing malaria, schistosomiasis, trichinosis and tapeworm infestation. Might his inflammatory burden be even greater than contemporary persons with rheumatic arthritis or lupus who develop premature atherosclerosis? And/or might exposure to the smoke from fires from cooking and light have injured endothelium enough to enhance atherosclerosis? What might the level of psychic stress been in ancient cultures?
Have we idealised ancient times and an ancient, paleo diet believing, hoping, that a return to our roots would be a panacea in the prevention of atherosclerosis? The findings of the Horus team have demonstrated that at least four different diets are not protective of atherosclerosis. However, an alternative interpretation of the study’s implications is that we as humans are all at risk, that we all have the capacity to develop atherosclerosis. Thus, we should do everything we can to minimise this risk in our patients and in ourselves. Our current understanding includes knowledge of multiple modifiable risk factors whose manipulation has resulted in a decade’s long diminishment in the development of atherosclerosis and its clinical manifestations in developing countries across the globe. What other modifiable risk factors might be discovered in the mummies of ancient people from across the globe?