Preclinical coronary atherosclerosis in a population with low incidence of myocardial infarction: Cross sectional autopsy study

Studies of autopsies indicate that atherosclerosis begins in childhood and is related to risk factors for coronary heart disease in the same way as for adult atherosclerosis.1 In Spain, despite risk factors for coronary heart disease being common, incidence of myocardial infarction and related mortality rates are among the lowest in the world.2 3 This paradox may be explained in two ways. One theory proposes that there is a time lag between increased consumption of animal fat and raised serum cholesterol concentrations, which have occurred more recently in Mediterranean populations than in other Western countries, and the expected increase in rates of coronary heart disease.4 An alternative explanation is that Mediterranean countries share behavioural and socioeconomic factors that prevent or delay atherogenesis.5 If this is true, the arteries of young Spaniards should be free from atheroma. We studied autopsies to evaluate the prevalence and severity of atherosclerosis in several arterial beds of young trauma victims from Barcelona. We report the results of left coronary artery evaluation. At …