CORONARY HEART DISEASE IN US SERVICEMEN. A FEW OBSERVATIONS.

I can across  this small, interesting study by Dr Bryant Webber from the Uniformed Service University of the Health Services, Bethesda, Maryland. This study is published in Journal of the American Medical association 308, 2577, 2012.
Dr Webber and colleagues studied the autopsy findings of servicemen who were killed in Afghanistan and compared their findings with earlier autopsy findings of servicemen killed in battle in the Korean war in the 50s and the Vietnam war in the 60s. The US military has this habit of doing postmortem on their servicemen after their death in battle or in the frontline.
What Dr Webber found was that there was much less atherosclerosis in the soldiers killed during this Afghan War. The incidence of atherosclerosis was only 8.5% and those with severe atherosclerosis was only 2.3%. Compare this with the soldiers killed during the Korean war ( atherosclerosis 77% ) and Vietnam war ( atherosclerosis 46% ).
What does this teach us?
1. That even fighting fit soldiers have assymptomatic atherosclerosis, some are even classified as severe.
2. The incidence of atherosclerosis is on the decline in the US, probably from their effective preventive program of diet, non-smoking, early control of blood pressure and dyslipidemia.
3. Assymptomatic atherosclerosis is compatible with normal life or even vigorous lifestyle.
4. Some of those who fought in the Korean and Vietnam war were conscripts whereas those who fought in the Afghan war were enrolled soldiers, meaning that they could have been better screen and so have a lower incidence of atherosclerosis.

Well we must continue with preventive programs for atherosclerosis, and encourage all to keep a healthy lifestyle. Those who do have investigative evidence of atherosclerosis but who has no symptoms should not panic. They probably need monitoring and medical therapy by their doctor.
We interventionist must learn to control our oculo-stenotic reflex, and not dilate for bread.