Atherosclerosis in Europeans and Bantu

Abstract

The atherosclerotic "profile" of the aorta, coronary, and cerebral arteries was gauged by the atherosclerotic index method of Gore and Tejada¹² in 540 unselected white and Bantu autopsy cases. The atherosclerotic indices were very low in all cases until about the third decade. Thereafter there was a progressive rise, which was most dramatic in the aorta and coronary arteries of white men. The aorta and coronary arteries of the white subjects were more severely affected than those of the Bantu whereas the cerebral arteries were about equally affected in the two racial groups. The 540 cases included 87 white men, 58 white women, 111 Bantu men, and 85 Bantu women over the age of 25 years. Of the 87 white men 10 had died from coronary occlusion and five from cerebrovascular accidents. Of the 111 Bantu men none died from coronary occlusive disease and seven of cerebrovascular accidents. Five of the 58 white women died at an advanced age from coronary occlusion; seven died from cerebrovascular accidents. None of the Bantu women died from coronary occlusion and seven from cerebrovascular accidents. Severe atherosclerosis was almost invariably present in cases that died from coronary occlusion suggesting that at least in white persons, coronary atherosclerosis directly predisposes to coronary occlusion. In patients who died from cerebrovascular accidents, macroscopically discernible atherosclerosis was not invariably present. It is suggested that the wide difference in the percentage of "coronary deaths" in the two ethnic groups is due to the much greater frequency of severe coronary atherosclerosis in white persons than in the Bantu. The close correlation between the percentage of "cerebral deaths" in white and Bantu subjects, on the other hand, is not merely the result of equal occurrence or equal susceptibility of the cerebral arteries to atherosclerosis in the two racial groups, but is rather the integrated result of one or more of the following factors: (1) the relative weakness of the cerebrovascular walls, (2) the relative common occurrence of cerebral artery aneurysms (congenital aneurysms), (3) such atherosclerosis as may be present, and (4) rise in blood pressure. Atherosclerosis of the cerebral arteries apparently played a somewhat more important role in white persons than in the Bantu.