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Down's syndrome and atherosclerosis
S Ylä-Herttuala1, J Luoma, T Nikkari
1Department of Biomedical Sciences, University of Tampere, Finland.
Insights
Patients with Down syndrome exhibit milder coronary artery atherosclerosis. Their arteries showed fewer raised lesions and less calcium compared to control groups, suggesting a protective effect.
Area of Science:
- Cardiovascular Science
- Genetics
- Pathology
Background:
- Down syndrome (also known as Trisomy 21) has been anecdotally linked to reduced atherosclerosis.
- Previous necropsy studies have yielded contradictory findings regarding cardiovascular health in Down syndrome patients.
Purpose of the Study:
- To investigate and compare the prevalence and severity of coronary artery atherosclerosis in individuals with Down syndrome versus control groups.
- To ascertain if Down syndrome confers protection against the development of atherosclerosis.
Main Methods:
- Macroscopic inspection of opened left coronary arteries.
- Biochemical analysis of the intima-media layer of coronary arteries.
- Comparison between Down syndrome patients, institutionalized mentally retarded patients, and normal free-living subjects.
Main Results:
- Coronary arteries from Down syndrome patients had a significantly lower percentage of raised lesions.
- Lower levels of calcium were detected in the coronary arteries of Down syndrome patients.
- Atherosclerosis was present but demonstrably milder in Down syndrome patients compared to both control groups.
Conclusions:
- Individuals with Down syndrome do not exhibit complete absence of coronary atherosclerosis.
- Down syndrome appears to be associated with a milder form of atherosclerosis compared to age-matched controls.
- Further research is warranted to elucidate the mechanisms behind this observed protective effect.
Abstract:
Necropsy findings in patients with Down's syndrome have suggested an absence of atherosclerosis throughout the cardiovascular system, but there are also contradictory results. We compared the left coronary arteries of 15 institutionalised Down's syndrome patients (5 males, 10 females, mean age 51 years) with those of 6 other institutionalised mentally retarded patients (4 males, 2 females, mean age 49) and 20 normal, free-living subjects (10 males, 10 females, mean age 48) by macroscopic inspection of the opened coronary arteries and by biochemical analysis of their intima-media. The arteries of Down patients contained a lower percentage of raised lesions and less calcium than the arteries of the control groups. Thus, even though the coronary arteries of mongoloids were not completely free of atherosclerosis, it was milder than in other mental patients and free-living subjects of the same age.