Atherosclerosis at autopsy in 12% of US service personnelBMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8698 (Published 28 December 2012) Cite this as: BMJ 2012;345:e8698
Among 3832 US service personnel who died in combat operations between 2000 and 2011, 12.1% had evidence of coronary or aortic atherosclerosis at autopsy. Some 8.5% had coronary atherosclerosis, which was severe in 2.3%. Most of those who died were men, and the mean age was 26 years.
Researchers analysed reports of autopsies, which were mandatory after all deaths during the two combat operations in Iraq and Afghanistan. The prevalence of incidental atherosclerosis was much lower than it had been in similar studies after the Korean (77%) and Vietnam (45%) wars, say the authors. Different study methods, sampling, and design may account for some of the decrease, but improvements in cardiovascular risk factors have probably contributed too. Defence personnel are no longer given cigarettes in their rations. Some defence facilities are smoke free, and others are likely to follow. Age was the strongest predictor of atherosclerosis in this study. Service members with atherosclerosis were about 5 years older on average than those without.
This and other autopsy studies remind us that atherosclerosis begins early, says a linked comment (p 2624). Prevalence may be falling in young men and others, but cardiovascular disease is still the leading cause of death in the US.
Cite this as: BMJ 2012;345:e8698