Ancient Egyptians did not smoke cigarettes, suffer significantly from obesity or have sedentary lives, so one might assume that they also had lower rates of atherosclerosis. However, new research has shown that even though these ancient people dodged many modern risk factors, patterns of atherosclerosis were surprisingly similar.

The study, published in Global Heart, the journal of the World Heart Federation, could shed light on previously unrecognized causes of atherosclerosis in the past while also informing research on underlying disease processes in the present, according to Adel H. Allam, MD, of Al-Azhar University in Cairo, and colleagues.

“Using the past to predict the future, as these ancient people unexpectedly had atherosclerosis, we need to continue to search for other potential fundamental causes of atherosclerosis. The discovery of new causes could dramatically reshape the frequency and impact of atherosclerosis today," they said.

Allam and colleagues compared CT scans of 76 Egyptian mummies dating from 3100 BCE to 364 CE with whole-body CT scans from 178 modern Egyptians. The images of modern patients were taken from PET/CT scans used for cancer staging.

Vascular calcification was present in 61 percent of modern patients and 38 percent of the ancient Egyptian mummies. However, there was a significant age gap between the two populations, with the mean age of the modern group at 52 years and the mean estimated age at death of the mummies set at 36 years. Vascular calcifications on CT strongly correlated with age, according to the authors, and if modern patients older than 60 were excluded from the analysis, the prevalence and severity of atherosclerosis was comparable between the two groups.

In trying to explain the findings, Allam and colleagues speculated that non-traditional causes of atherosclerosis could be to blame. Frequent bacterial and viral infections in an unhygienic ancient environment could have induced prolonged inflammatory responses that accelerated the atherosclerotic process. And while tobacco was not available to ancient Egyptians, smoke inhalation could come from other sources.

"We noticed a trend toward more women than men developing atherosclerosis in ancient times,” noted the authors. “The traditional role of women in these times, cooking over a fire for much of the day, could have represented the scourge of smoking of the time. Inhalation of smoke day-in and day-out could have initiated and propelled the atherosclerotic process."