Abstract
The Global HORUS study aimed to determine how widespread atherosclerosis was in a large sample of mummified individuals. Adult mummies housed in 29 different museums and collections from around the world were studied with whole body CT scanning and were systematically reviewed for atherosclerotic arterial calcifications, interpreting by consensus. Sex and estimates of age at the time of death were established by participating bioarcheologists. Era of antiquity was obtained from museum records and, in 34 cases, from carbon-14 dating. Calcification in the wall of an identifiable artery was considered definite atherosclerosis and calcification along the expected course of an artery was considered probable atherosclerosis. Mummified remains derived from 7 different ancient populations (ancient Egyptians, ancient lowland Peruvians, ancient highland Andean, 19th century Unangan/Aleutian Islanders, 16th century Inuit, ancestral Puebloan, Middle-Ages Mongolian, plus a 19th century African American and an Indigenous Australian; females 36%, mean estimated age-at-death 40y) were examined. Definite or probable atherosclerosis was seen in 97 individuals (39%). Atherosclerotic calcifications were more common in longer-lived individuals (p<0.05) and were found in similar frequencies in Egyptians vs. non-Egyptians and in males vs. females.
Except for the single Indigenous Australian in which no vascular tissue was present, atherosclerosis was seen in all populations over a time span of more than 4,000 years. The Global HORUS study has not found a population which does not have evidence for atherosclerosis. While histologic confirmation was not performed, atherosclerosis has been histologically documented in other mummified remains. In conclusion, atherosclerosis has been present in humans across the globe and in numerous populations since ancient times, consistent with a genetic predisposition to atherosclerosis. Genetic trade-offs including antagonistic pleiotropy likely play a fundamental role. This study, along with others, establishes that atherosclerosis is part of the human condition.