© 2000 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
Effects of Coronary Heart Disease Risk Factors on Atherosclerosis of Selected Regions of the Aorta and Right Coronary Artery
From the University of Texas Health Science Center at San Antonio (H.C.M., C.A.M.); the Southwest Foundation for Biomedical Research (H.C.M.), San Antonio; Ohio State University (E.E.H.), Columbus; and the Louisiana State University Medical Center (R.E.T., G.T.M., A.W.Z., J.P.S.), New Orleans.
Correspondence to Henry C. McGill, Jr, MD, Southwest Foundation for Biomedical Research, PO Box 760549, San Antonio, TX 78245-0549. E-mail jstron{at}lsumc.edu
Abstract—We examined topographic
distributions of atherosclerosis and their relation to
risk factors for adult coronary heart disease in right
coronary arteries and abdominal aortas of more than 2000
autopsied persons 15 through 34 years of age. We digitized images of
Sudan IV–stained fatty streaks and of manually outlined raised lesions
and computed the percent surface area involved by each lesion in each
of 6 regions of each artery. In abdominal aortas of 15- to 24-year-old
persons, fatty streaks involve an elongated oval area on the
dorsolateral intimal surface and another oval area in the middle third
of the ventral surface. Raised lesions in 25- to 34-year-old persons
involve an oval area in the distal third of the dorsolateral intimal
surface. In other areas of the abdominal aortas of older persons, fatty
streaks occur but raised lesions are rare. In the right
coronary arteries of 15- to 24-year-old persons, fatty streaks
are most frequent on the myocardial aspect of the first 2 cm. Raised
lesions follow a similar pattern in 25- to 34-year-old persons. High
non-HDL cholesterol and low HDL cholesterol
concentrations are associated with more extensive fatty streaks and
raised lesions in all regions of both arteries. Smoking is associated
with more extensive fatty streaks and raised lesions of the abdominal
aorta, particularly in the dorsolateral region of the distal third of
the abdominal aorta. Hypertension is not associated with fatty streaks
in whites or blacks but is associated with more extensive raised
lesions in blacks. Risk factor effects on arterial regions
that are vulnerable to lesions are 
25% greater than risk factor
effects assessed over entire arterial segments. These risk
factor effects on vulnerable sites emphasize the need for risk factor
control during adolescence and young adulthood to prevent or delay the
progression of atherosclerosis.
Key Words: atherosclerosis • aorta • coronary artery • topography • risk factors
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