RISK-FACTORS AND ATHEROSCLEROSIS IN YOUTH AUTOPSY FINDINGS OF THE BOGALUSA HEART-STUDY

The Collaborative Pathology Study is one of the most impressive progra ms of the Bogalusa Heart Study. Attempts are made to obtain complete a nd uniform necropsy coverage of all deceased young people who may have been examined in the Bogalusa Heart Study, Since 1978, autopsy specim ens have been collected from 190 deaths, representing 65% of all known deaths in the study age category, The relation of antemortem risk fac tors for cardiovascular disease to early atherosclerotic lesions in th e aorta and coronary arteries was assessed in those individuals previo usly examined in the Bogalusa Heart Study (N = 59). Aortic fatty strea ks were strongly related to both total and low-density lipoprotein (LD L) cholesterol (r = 0.62, P < 0.0001 for each association), and were i nversely correlated with the ratio of high-density lipoprotein (HDL) c holesterol to LDL plus very-low-density lipoprotein (VLDL) cholesterol (r = -0.29, P < 0.01), Coronary artery fatty streaks were associated with elevated total cholesterol, LDL cholesterol, VLDL cholesterol, an d systolic blood pressure. Higher levels of LDL and VLDL cholesterol, triglycerides, systolic and diastolic blood pressure, and a lower rati o of HDL to LDL plus VLDL were found in those people with coronary art ery fibrous plaques. Microscopy offered additional information about t he characteristics of the aortic and coronary arterial intimal disease . Histologic observations have confirmed some of the relationships ind icated with gross observations and show the complexity of this disease process. These findings emphasize the importance of an approach to pr eventive cardiology early in life.