Atherosclerosis often starts in childhood and frequently continues to increase in
severity throughout life. The 1992 Bogalusa Heart Study examined the blood vessels
of children who died in accidents. It found that the children, who ate a typical
American diet, already had fatty streaks and plaques on their arteries—the signs
of early atherosclerosis. A 1998 autopsy study found that the prevalence of fatty
streaks in the coronary arteries increased with age, from approximately 50% at age
2 to 15, to 85% at age 21 to 39; and the prevalence of coronary raised fibrous-plaque
lesions increased from 8% at ages 2 to 15 years to 69% at ages 26 to 39.
In a 1953 study, pathologists examining the coronary arteries of young men (average
age 22) who were killed in the Korean War were surprised to find that 77.3% of
American soldiers had easily visible evidence of atherosclerosis—and sometimes
it was severe. In contrast, the dead Korean and Chinese soldiers who lived on a
plant-based diet were virtually free from atherosclerosis. In 1971, similar studies
among Vietnam War combat dead found that 45% of those examined had evidence
of coronary atherosclerosis, and among 5%, the disease was severe.
A more recent study among U.S. servicemen who died from accidental injuries
found lower levels of coronary atherosclerosis. While not entirely comparable
to the earlier studies, autopsies carried out between 2001 and 2011 found coronary
atherosclerosis of any severity among 8.5% of those studied. It was minimal in
1.5%, moderate in 4.7%, and severe in 2.3%. The low levels of atherosclerosis may
be accounted for by the low levels of risk factors present in this young (average age
27) population compared to the general public. Only 4% were obese, 3% smoked,
1% had high blood pressure, 0.7% had cholesterol levels higher than 240 mg/dl, and
0.2% had high fasting blood glucose levels.
The 2001 to 2011 studies of U.S. servicemen should not be considered a reason
for complacency about cardiovascular disease. Those aged 40 or older were seven
times more likely to have coronary atherosclerosis than those age 24 and younger.
Among those ages 30 to 39, the prevalence of aortic and/or coronary atherosclerosis
was 22.1%, and among those aged 40 or older, it was 45.9%.
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