Autopsy Studies in Atherosclerosis

Abstract

The incidences of obesity, hypertension, nephrosclerosis, and rheumatic carditis in 500 adult patients were noted at autopsy, and were correlated with the distribution and severity of concomitant atherosclerosis. In men, obesity uncomplicated by hypertension was associated with a significant increase in the severity of coronary atherosclerosis and the occurrence of cardiac catastrophes. Uncomplicated obesity in women appeared to have no effect upon concomitant atherosclerosis. Hypertension in men was associated with significantly increased coronary and cerebral atherosclerosis, and with a greater occurrence of myocardial infarction. Hypertensive women had significantly more severe atherosclerosis than normotensive women in most of the arteries studied, and also had significantly more myocardial infarcts. The atherosclerosis of patients who had nephrosclerosis was similar in distribution and severity to that of patients who had hypertension. The presence of rheumatic carditis appeared not to influence the extent or severity of concomitant atherosclerosis.

Relationship Between Aortic Plaques and Age, Sex, and Blood Pressure

“…Previous studies have failed to clarify the relationship between blood-pressure and arterial disease, confusion having been introduced by the grouping of all types of lesion together as " atherosclerotic," and by the use of heart weight as an index of high blood-pressure (Wilkins et al, 1959 ;Sacks, 1960). The finding of plaques in the pulmonary arteries of patients with mitral stenosis, such lesions being uncommon in normal patients, led Turnbull (1915) to suggest that pulmonary hypertension might play a part in their development.…”

Arteriosclerotic Massive Hypertrophy of the Heart

“…Nevertheless, it was thought necessary to take an additional precaution to eliminate the possibility of the cardiac hypertrophy being due to unrecognized hypertension. Hypertension often results in coronary arteriosclerosis and myocardial infarction, and the high blood pressure may fall permanently to a normal level after acute myocardial infarction (4–7). Therefore, pre‐existing hypertension had to be ruled out as a cause of both the arteriosclerosis and the hypertrophy.…”

“…Moderate cardiac hypertrophy is frequently present in uncomplicated coronary artery disease (1–6). Massive hypertrophy, when present, is said to be due to concomitant unrecognized hypertension (3, 5, 7). Nevertheless, in many of the series reported in the literature, there are individual cases in which arteriosclerotic coronary artery disease resulted in heart weights of more than 600 grams (1, 2, 6, 8).…”