Aortic and Coronary Atherosclerosis in the Three Racial Groups in Cape Town

Abstract

An autopsy survey of aortic and coronary atherosclerosis in patients dying in a general hospital in Cape Town has shown marked differences between the whites and the Bantu. These differences were clearly demonstrated by a direct comparison of Bantu and White men between the ages of 40 and 59. They probably also existed among older subjects and women although relatively few Bantu over the age of 60, and fewer women than men were unfortunately available for study. Severe aortic and coronary atherosclerosis did on occasions occur in the Bantu but were much less common than in the whites. Severe luminal narrowing of the coronary arteries was particularly rare in the Bantu, and this is in keeping with the rarity with which they develop myocardial infarction. The aorta and coronary arteries of the Bantu often showed complete freedom from atherosclerosis in age groups in which it was rare to find such freedom in the whites. The differences between the whites and Cape Coloured were much less pronounced than those between the whites and Bantu, were rather more apparent in men than women, and tended to disappear in the presence of aggravating factors such as hypertension. Even in groups in which severe coronary atherosclerosis was as commonly encountered in the Cape Coloured as in the whites, the Cape Coloured appeared to show a lower frequency of severe luminal narrowing. Attention has been drawn to the possibility that the differences between the total white and Cape Coloured populatios of Cape Town are greater than those revealed by this study, as only the lesser economically privileged of the whites were eligible for admission to the hospital that provided the material for the study.