1. Is atherosclerosis a disease of modern human beings? Atherosclerosis across 4000 years of human history Thompson RC et al. Lancet. 2013;381:1211-1222. The Lancet April 2013 The Lancet April 2013

2. Evaluation of preindustrial populations 137 Mummies from 4 different geographical regions or populations spanning more than 4000 years. – Individuals from ancient Egypt. – Individuals from ancient Peru. – Ancestral Puebloans of southwest America. – Unangan hunter-gatherers of the Aleutian Islands. Whole-body computed tomography scans Atherosclerosis identified by presence of : – Calcified plaque in the artery wall. – Calcification along the expected course of an artery. 137 Mummies from 4 different geographical regions Thompson RC et al. Lancet. 2013;381:1211-1222.

3. Atherosclerosis was common in all populations Atherosclerosis was noted in 34% of mummies: 38% Ancient Egyptians. 25% Ancient Peruvians. 40% Ancestral Puebloans. 60% Unangan hunter-gatherers. (without significant difference between the groups) Thompson RC et al. Lancet. 2013;381:1211-1222. Figure 1. Bilateral carotid, bilateral subclavian, and brachiocephalic calcifi cation.

4. Positive correlation between age at time of death and atherosclerosis Those with atherosclerosis were older at time of death. Mean age at death was 43 years for mummies with atherosclerosis versus 32 years for those without (P<0.0001). Thompson RC et al. Lancet. 2013;381:1211-1222.

5. Atherosclerosis was common in 4 preindustrial populations, including a preagricultural hunter-gatherer population, and across a wide span of human history. Atherosclerosis remains prevalent in contemporary human beings. The presence of atherosclerosis in premodern human beings suggests that the disease is an inherent component of human aging and not characteristic of any specific diet or lifestyle. Note that atherosclerosis is not the unique cause of ischemia, and that ischemic heart disease is a multifactorial disease. Conclusion: