ABSTRACT
When the author was in medical school he was taught that atherosclerosis was a degenerative disease, and that if we lived long enough we could expect a good deal of it. He have examined the hearts of six people who lived 100 years or longer. Although four had one or more major epicardial coronary arteries narrowed >75% in cross-sectional area by plaque, none had had apparent clinical evidence of myocardial ischemia or congestive heart failure during life. Two of the six patients had insignificant coronary narrowing. In one of the two, the four major (right, left main, left anterior descending, and left circumflex) epicardial coronary arteries were divided into 5 mm segments and a histologic section was prepared from each segment. All the resulting 45, 5 mm segments, were narrowed <25% in cross-sectional area. Thus, coronary narrowing does not have to be a consequence of living 100 years.
