She didn't smoke. Never ate a double bacon cheeseburger. Never sacked out on the couch watching cable TV. Yet by the time she reached her early 40s, she was a candidate for a heart attack.
That was nearly 3,600 years ago.
Princess Ahmose-Meryet-Amon of Egypt's 17th Dynasty had the world's oldest known case of coronary heart disease, researchers say.
Atherosclerosis -- commonly called hardening of the arteries -- was surprisingly widespread in ancient times, at least among the Egyptian mummies examined by an international team of scientists and heart specialists.
Their research, presented recently in New Orleans at the annual meeting of the American College of Cardiology, found that 45 percent of the mummies they put through CT scans had signs of atherosclerosis.
That raises questions about whether hardening of the arteries is the disease of modern civilization that we thought it was.
"We found it so easily and frequently that it appears to have been common in this society," said Randall Thompson, a cardiologist at St. Luke's Hospital in Kansas City.
"It was so common we have to wonder, are we missing something? Maybe we don't understand atherosclerosis as well as we think. Maybe there's a missing risk factor we haven't found yet."
Thompson and the other researchers performed CT scans on 52 mummies, mostly from the Egyptian National Museum of Antiquities in Cairo. It was the largest number of mummies ever assembled for such a study.
Among the 44 mummies with hearts or identifiable blood vessels, 20 probably or definitely had atherosclerosis.
Atherosclerosis occurs when fatty material collects along artery walls. As this material thickens and hardens, it might block the arteries.
Heart disease found
The researchers found atherosclerosis most often in the aorta, the body's main trunk artery. In some mummies, the condition was found in arteries supplying blood to the legs or the pelvis. In eight mummies, arteries to the brain were affected, suggesting that these ancients might have been at risk of stroke.
"It looks like atherosclerosis you see on a CT scan of modern patients," Thompson said.
Three mummies, including the princess, had signs of atherosclerosis in the coronary arteries that supply blood to the heart. Blockages in these arteries can lead to chest pains or heart attack.
"It was so advanced in her case, she may have well have had clinical disease," Thompson said. "She could have had chest pains if she had lived longer."
Princess Ahmose-Meryet-Amon was among the oldest mummies the researchers examined, but atherosclerosis was found in mummies of people who had lived over a span of about 2,000 years of Egyptian history.
As with modern people, the likelihood that a mummy had atherosclerosis increased with age. But ancient Egyptians weren't like modern people, or so we thought.
"They didn't smoke. They didn't eat trans fats," Thompson said.
A major modern problem
Diseases of the heart and blood vessels are now among the world's leading causes of death. Most Americans have some atherosclerosis by the time they are in their 50s.
The problems have spread to developing countries. That has made it easy to view cardiovascular diseases as exclusively modern maladies that didn't affect our ancient ancestors, the researchers said.
The mummies included in the study all probably came from among the elite and wealthy, Thompson said. But even if these ancient Egyptians ate a richer diet and were more sedentary than their contemporaries, they still had a lot of cardiovascular disease to account for, Thompson said.
Perhaps genetic factors predisposed the Egyptians to atherosclerosis, he said. Or maybe infections, which were more common in ancient times, promoted the disease.
Thompson said the research team hopes to study mummies of less elite people who might have been more active and eaten plainer diets.
The ancient Egyptians certainly were familiar with the critical symptoms of heart disease, if not its causes.
As an ancient papyrus scroll for a physician said: "If thou examinist a man for illness in [the region of his heart] and he has pains in his arms, in his breasts and on one side ... it is death threatening him."