Is atherosclerosis a consequence of aging and therefore a degenerative disease?
No. When I was in medical school, I was taught that atherosclerosis was a disease of aging and that it was to be expected as we got older. It is true that symptomatic and fatal atherosclerosis is usually a problem of older people. But, not too old. Patients with homozygous familial hypercholesterolemia, however, may have lipid plaques in their arteries at the time of birth. It appears that atherosclerosis requires certain serum cholesterol levels over certain periods of time. Therefore, if one has a serum total cholesterol of 1000 mg/dL, death usually occurs by age 15 (without lipid-lowering therapy). Those with total cholesterol levels of approximately 300 mg/dL live into their 30s and 40s. The average age of death from coronary artery disease in the USA is 60 years in men and 68 years in women (7). Sudden death is primarily a problem of young men. Therefore, those who make it to the hospital are usually older than these ages. Nevertheless, atherosclerosis is a disease of relatively y
