NATURAL-HISTORY AND RISK-FACTORS FOR EARLY HUMAN ATHEROGENESIS

A multi-institutional study, Pathobiological Determinants of Atheroscl erosis in Youth (PDAY), was initiated to document the natural history of atherosclerosis, its relationship to risk factors, and the pathobio logy of lesion development in young subjects. Pathology laboratories i n nine centers collected arteries and tissues from >2000 persons, ages 15-34 years, whose deaths were attributed to homicides, accidents, or suicides. Arteries were evaluated for lesions, and risk factors were analyzed in a central laboratory. Postmortem risk factors include seru m lipoproteins, serum thiocyanate (smoking), glycohemoglobin (diabetes ), thickness of panniculus adiposus (obesity), changes in small renal arteries (hypertension), and apoprotein isoforms. This PDAY study docu ments the development of atherosclerosis at an early age and shows tha t the recognized risk factors for coronary heart disease are associate d with lesion development in the arteries of these young subjects. The findings provide a strong justification for reducing risk factors in young persons.