September 25, 1996

Can Genes Prevent Atherosclerosis?

Author Affiliations

From the Molecular Disease Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md.

JAMA. 1996;276(12):989-992. doi:10.1001/jama.1996.03540120067036

SELECTED CASE  A 59-year-old white woman had a blood cholesterol concentration determined on routine screening. The total plasma cholesterol level was 9.1 mmol/L (351 mg/dL). She had salpingo-oophorectomy and hysterectomy at 44 years of age, and she had no illness indicative of cardiovascular disease. Not only was her family without evidence of premature cardiovascular disease, but she also had family members on both the maternal and paternal sides who lived long lives. Her maternal grandfather and great-grandfather lived to be 96 and 102 years of age, respectively, despite lifelong cigarette use. Her maternal grandmother lived to be 72 years old despite morbid obesity. Diabetes mellitus and hypertension were not evident within this patient's kindred. After a brief trial of lovastatin, the patient was referred to the National Institutes of Health (NIH) for evaluation.The patient had no medical complaints upon admission and physical examination disclosed no evidence of atherosclerotic vascular