Coronary Heart Disease in Ancient Egyptians

The study of ancient medical history usually relies on documents and objects as sources. Ancient Egyptian medicine is unique because in addition to the ten medical papyri which date from 1550 BCE and objects and tomb drawings historians and biologists have had unparalleled access to human preserved material in the form of mummified remains.

In the 19th century it was not uncommon for people to be invited to the "unrolling" of a mummy brought back from excavations in the middle east. More recently multi-disciplinary teams have come together to investigated mummies in museum collections and from newly excavated sites using non-invasive and tissue sparing techniques such as CT scanning, endoscopy and molecular biology. This has allowed the study of wrapped mummies and allowed these remains to be preserved intact. This work has led to some fascinating insights into the types of diseases present in our ancient ancestors who live over 4000 years ago.

For the cardiologist coronary artery disease and atheroscleorsis are often thought of as 20th century problems caused by diet, smoking habits, exercise patterns and lifestyle. It is often said that if we were able to get back to a more primitive diet and to have the daily exercise of the ancient hunter-gatherers then heart disease would be a thing of the past. We also think of hardening of the arteries (so called calcification) as a problem of the elderly person with coronary artery disease, not seen commonly in middle aged individuals.

So it is of great interest to see the publication of the HORUS study which has looked for evidence of vascular disease in 137 mummies from around the world (ancient Egypt, ancient Peru, the Ancestral Puebloans of southwest America and the Unangan of the Aleutian Islands).  Using whole body CT scanning atherosclerosis was identifed by looking for the presence of calcified plaque in the wall of an artery. Atherosclerosis was noted in just over a third of mummies and in 4% of coronary arteries. This does not seem like a high proportion in the coronary arteries but we have to bear in mind that the average age of the mummies at death was 38 years.

Although we commonly assume atherosclerosis to be a modern disease it was certainly present in pre-modern human beings and this raises significant questions about the basic predisposition and also the influences of lifestyle on the development of the atherosclerosis.

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Coronary artery disease. Sagittal 3D-volume rendered (A) and sagittal oblique 3D volume rendered (B) CT reconstruction of two mummies with coronary calcifications. (A) Coronary calcifications in the mummy of a Unangan woman (mummy 133) aged 47–51 years who lived in the late 19th century CE and was found on Kagamil Island of the Aleutian Islands. (B) Coronary artery calcifications in the mummy of Ahmose-Meritamun (mummy 35), an Egyptian princess aged 40–45 years who lived about 1580–1550 BCE and was found near modern day Luxor. RCA=right coronary artery. CE=common era. BCE=before common era

Atherosclerosis across 4000 years of human history: the Horus study of four ancient populations.
AR David: Disease in Mummies: The contribution of new technologies. Lancet
Professor Rosalie David, Manchester University

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