By Natasha Singer in The New York Times:
The Book of Exodus in the King James translation of the Bible describes a pharaoh who “hardened his heart” against the exodus of the Jews from ancient Egypt. But if a research letter published last week in The Journal of the American Medical Association is correct, the pharaoh may have been suffering from hardened arteries.
The new report recounts how a team of cardiologists used CT scanning on mummies in the Egyptian National Museum of Antiquities in Cairo to identify atherosclerosis — a buildup of cholesterol, inflammation and scar tissue in the walls of the arteries, a problem that can lead to heart attack and stroke.
The cardiologists were able to identify the disease in some mummies because atherosclerotic tissue often develops calcification, which is visible as bright spots on a CT image. The finding that some mummies had hardened arteries raises questions about the common wisdom that factors in modern life, including stress, high-fat diets, smoking and sedentary routines, play an essential role in the development of cardiovascular disease, the researchers said.
“It tells us that we have to look beyond lifestyles and diet for the cause and progression of this disease,” said Dr. Randall C. Thompson, a cardiologist at St. Luke’s Mid America Heart Institute in Kansas City, Mo., and part of the team of cardiovascular imaging specialists who traveled to Cairo last year. “To a certain extent, getting the disease is part of the human condition.”
Last February, the team of cardiologists — one Egyptian and four American — conducted whole-body scans of 20 of the museum’s mummies that were well preserved and thus likely to have identifiable arteries. The study also included two mummies that had been scanned by other researchers.
Sixteen of the people mummified had been members of a pharaoh’s court, among them two priests, a king’s minister and his wife, and a nursemaid to a queen. They lived between 1981 B.C. and A.D. 334, the cardiologists said.
Among the 16 mummies that had identifiable cardiovascular tissue, there were 5 confirmed and 4 probable cases of atherosclerosis.
The researchers found calcification in the leg arteries and the aorta of some mummies, which means that these ancient Egyptians had risk factors for problems like strokes and heart attacks — though not necessarily that they had developed heart disease before they died. As with modern humans, arterial calcification was more prevalent among the mummies who lived longer. The study’s small sample and the subjects’ high socioeconomic status may mean the findings do not extend to more ordinary ancient Egyptians, said Dr. Adel H. Allam, the Egyptian cardiologist on the team.
“They were rich people, and the habit of diet and physical activity could be a little bit different than other Egyptians who lived at that time,” said Dr. Allam, an assistant professor of cardiology at the Al Azhar Medical School in Cairo.
The group hit upon the idea of examining mummies for arterial disease in 2007, when another cardiologist, Dr. Gregory S. Thomas, was visiting Dr. Allam in Cairo and happened upon a mummified pharaoh named Menephtah in the museum. A plaque by Menephtah’s case explained that the pharaoh, who died about 1200 B.C., had been afflicted with atherosclerosis.
Dr. Thomas, a clinical professor of medicine and cardiology at the medical school of the University of California, Irvine, did not believe it.
“For one thing, how would they know?” Dr. Thomas said in a phone interview last week from Cairo. “For another thing, what would people be doing with atherosclerosis 3,000 years ago, without tobacco, with an all-natural diet and, presumably, with much more walking?”
Egypt’s Supreme Council of Antiquities gave permission for the team to scan a group of mummies, provided that none were royalty. The team used a CT scanning system, housed in a trailer at the back of the museum, that had been donated by the medical device maker Siemens and had been used by a different team in 2005 to scan Tutankhamen. Siemens, the National Bank of Egypt and St. Luke’s Mid America Heart Institute were sponsors of the study.
The oldest mummy in whom the group found hardened arteries was Lady Rai, a nursemaid to a famous queen, who died in about 1530 B.C. when she was between 30 and 40 years old. Dr. Thompson said the calcification in her aorta looked similar to that in images of his own patients with atherosclerosis in Kansas City.
“She went in a relic,” Dr. Thompson said of the mummified Lady Rai. “She came out a patient.”
Modern habits have long been linked to cardiovascular disease in the public mind — in part, said Dr. Roger S. Blumenthal, director of the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins, because of correlations like the one between smoking and heart disease.
Heart disease increased in the 20th century as more people took up smoking. Then it declined after the surgeon general’s famous warning in 1964, said Dr. Blumenthal, who is not affiliated with the mummy researchers.
But Dr. Thomas says he now views arterial buildup as being more like wrinkles — a human condition whose progression may be inhibited by behavior like avoiding cigarettes and too much sunlight, but which is ultimately inevitable. If that is the case, he said, preventive lifestyle changes become even more important.
“You have to think about it differently if everyone is going to get it,” Dr. Thomas said. “I don’t want to say it is something we can prevent, but it is something we can delay.”