Atherosclerosis of the aorta and coronary vessels of the heart in cases of various diseases

Abstract

The authors investigated the occurrence of atherosclerosis in “healthy” people (selected accidental deaths), in people, who died of complications due to atherosclerosis, and in some diseases: i.e. , diabetes, hypertensive disease, renal hypertension and malignant tumours. In their observations, they used the visuo-planimetric method of estimation of vascular atherosclerotic changes recommended by the WHO. In diabetics under the age of 50, extensive atherosclerosis was found in only 16 of the 38 patients. In some of these 16 cases, the duration of diabetes was over 8 years (in 8 cases). The accelerated development of atherosclerotic changes (mostly fibrous plaques) was usually observed in 1 or 2 vessels out of the 5 studied. In some instances, despite a long duration of diabetes in young people, the authors did not note any accelerated development of atherosclerotic changes as compared with the control groups. In people of 50 years of age and over, atherosclerotic changes in diabetics were as pronounced as in those who died of atherosclerosis unattended with diabetes. Hypertension of any etiology (essential, renal) involves a more pronounced atherosclerosis of the aorta than found in healthy people or those who died of complications due to atherosclerosis unattended with hypertension. The average area of atherosclerotic changes in the right coronary artery in patients with essential hypertension is larger than in persons who died of complications due to atherosclerosis but did not suffer from hypertension. The differences in the descending branch of the left coronary artery are less pronounced, although there is a tendency towards more severe lesions of this vessel in patients with essential hypertension, especially in men. In patients 30–39 years of age suffering from symptomatic renal hypertension, atherosclerosis of the aorta is more intensive than in patients with essential hypertension. There is also a tendency towards an increase in the area of atherosclerosis of the coronary arteries in patients suffering from symptomatic hypertension, especially between the ages of 30 and 39. After 40, the intensity of atherosclerosis in these two groups is essentially the same. In cases of new malignant growths, atherosclerotic changes in the aorta and coronary arteries were less prevalent than in cases of other ailments studied (diabetes, essential hypertension, symptomatic hypertension). In their prevalence, however, they differed little from atherosclerotic changes in healthy people.