“To­day, she would have needed by­pass surgery,” said Greg­o­ry S. Thom­as of the Uni­vers­ity of Cal­i­for­nia, Ir­vine, the stu­dy’s co-principal in­ves­ti­ga­tor, of Prin­cess Ah­mose-Mer­yet-Amon of Egypt. Cor­o­nary ar­tery dis­ease is a blood ves­sel ob­struc­tion that can lead to heart at­tack, an­gi­na and death, and of­ten re­sults from sed­en­tary lifestyles or too much fat­ty food. 

The find­ings sug­gest that as a spe­cies we “are pre­dis­posed to ath­er­o­scle­ro­sis,” said co-in­ves­ti­ga­tor Ran­dall C. Thomp­son of the St Luke’s Mid-America Heart In­sti­tute in Kan­sas ­city. This should­n’t prompt peo­ple to give up on ward­ing it off, he stressed, as it re­mains as true as ev­er that prop­er di­et, ex­er­cise and avoid­ance of smok­ing can help do so.

Scanned im­ages of the Egyp­tian roy­al’s cor­o­nary ar­ter­ies are fea­tured in two pre­s­enta­t­ions at the In­terna­t­ional Con­fer­ence of Non-Invasive Car­di­o­vas­cu­lar Im­ag­ing this week in Am­ster­dam. The prin­cess, now the first per­son in his­to­ry with di­ag­nosed cor­o­nary ar­tery dis­ease, lived in Thebes (mod­ern-day Lux­or) in the mid-1500s B.C. Her di­et was rich in veg­eta­bles, fruit and a lim­it­ed amount of meat from do­mes­ti­cat­ed an­i­mals, sci­en­tists said. Bread and beer were the di­etary sta­ples of this pe­ri­od of an­cient Egypt, they added; to­bac­co and trans-fats were un­known, and lifestyles were usu­ally ac­tive.

Thom­as and col­leagues in­ves­ti­ga­ted 52 an­cient Egyp­tian mum­mies for signs of ar­te­ri­al ath­er­o­scle­ro­sis, a hard­en­ing of the ar­ter­ies that leads to cor­o­nary ar­tery dis­ease. They found recog­nis­able ar­ter­ies in 44 mum­mies and an iden­ti­fi­able heart in 16. A mark­er of ath­er­o­scle­ro­sis was ev­i­dent at a va­ri­e­ty of sites in al­most half the mum­mies scanned, prompt­ing the in­ves­ti­ga­tors to note that the con­di­tion was com­mon in this group of mid­dle aged or old­er an­cient Egyp­tians. The 20 mum­mies with def­i­nite ath­er­o­scle­ro­sis were aged 45 years on av­er­age, about 10 years old­er than those with in­tact vas­cu­lar tis­sue but no ap­par­ent ath­er­o­scle­ro­sis.

“Over­all, it was strik­ing how much ath­er­o­scle­ro­sis we found,” said Thom­as.

A CT scan indicated the prin­cess, who died in her 40s, had ath­er­o­scle­ro­sis in two of her three main cor­o­nary ar­ter­ies, lead­ing to a di­ag­no­sis of cor­o­nary ar­tery dis­ease. But how could this “dis­ease of mod­ern life” af­fect a wom­an who probably ate healthy food, and dur­ing a time when la­zy lifestyles were rare? 

Thom­as and co-principal in­ves­ti­ga­tor Adel Al­lam of Al Azhar Un­ivers­ity, Cai­ro, sug­gest three pos­si­bil­i­ties. First, there may­be still some un­known risk fac­tor for cardiovas­cu­lar dis­ease, per­haps an as-yet un­iden­ti­fied ge­net­ic link. Sec­ond, an in­flam­ma­to­ry re­sponse to the fre­quent par­a­sit­ic in­fec­tions com­mon to an­cient Egyp­tians might pre­dis­pose to cor­o­nary dis­ease, much as HIV pa­tients with com­pro­mised im­mune sys­tems seem al­so pre­dis­posed to early cor­o­nary dis­ease. 

Third, a di­etary cause can’t be ruled out. As an aris­to­crat and daugh­ter of Se­qe­nenre Ta­o II, the last phar­aoh of the 17th Dyn­as­ty, the prin­cess’s di­et was probably not that of the com­mon Egyp­tian. She would have ea­ten more lux­u­ry foods such as meat, but­ter and cheese. More­o­ver, foods were pre­served in salt, per­haps pos­ing ad­di­tion­al health risks.