Autopsy-Determined Atherosclerosis in Elite US Military Special Operations Forces

Area of Science:

• Cardiovascular Pathology
• Military Medicine
• Public Health

Background:

• Autopsy studies reveal atherosclerosis is common in young and middle-aged adults.
• Elite US military forces represent a unique demographic for studying cardiovascular health.
• Understanding atherosclerosis prevalence in this population is crucial for health assessments.

Purpose of the Study:

• To determine the prevalence of atherosclerosis in elite US military Special Operations Forces (USSOCOM).
• To analyze atherosclerosis distribution across various demographic and occupational subgroups.
• To assess the severity of coronary and aortic atherosclerosis in combat fatalities.

Main Methods:

• Retrospective analysis of 356 USSOCOM fatalities from 2001-2020 due to battle injuries.
• Autopsies examined for coronary and/or aortic atherosclerosis, categorized as minimal, moderate, or severe.
• Prevalence determined by age, sex, race/ethnicity, combat operation, occupation, rank, BMI, and cause/manner of death.

Main Results:

• Overall atherosclerosis prevalence was 17.4% (coronary alone: 13.8%) in fatalities with a mean age of 31.
• Severe atherosclerosis was present in 5.1% of cases.
• Atherosclerosis was more common in those under 30 (24.2%), enlisted ranks (88.7%), and combat occupations (95.2%).
• Overweight/obesity (BMI ≥25) was noted in 73.5% of fatalities with atherosclerosis.

Conclusions:

• Autopsy-determined atherosclerosis is prevalent in elite US military Special Operations Forces.
• The findings challenge assumptions about cardiovascular health in young, elite military personnel.
• Further research is warranted to explore risk factors and preventive strategies within this population.