Atherosclerosis is thought to be a disease that occurs in modern populations, and its occurrence and development are closely related to modern lifestyles. However, recent evidence suggests that atherosclerosis as a disease has been widely prevalent in ancient populations with different cultural backgrounds and lifestyles, suggesting that the causes of atherosclerosis need to be further explored and reflected upon. In 1852, the Austrian physiologist Czermak JN found atherosclerotic plaques in the aorta of an elderly Egyptian female mummy during autopsy, which was the first evidence of atherosclerosis in ancient Egyptians. In 1931, Long AR performed a cardiac examination of the mummy Mrs. Teye (1070 945 B.C.) from the Metropolitan Museum of Art in New York and found intimal thickening and calcification of the coronary arteries, myocardial fibrosis and myocardial infarction, which provided histological evidence for the diagnosis of coronary artery atherosclerosis. In 2009, Allam AH et al. from the University of California examined 22 mummies preserved in the Egyptian National Museum by CT to investigate their atherosclerotic lesions during their lifetime. Prior to the study, the mummies were identified by a paleontological anthropologist for sex and age, and the demographic data were analyzed and evaluated by an Egyptian archaeologist and mummy preservationist. The mummies were identified as dating from 1881 BC to 334 AD, and 16 of the mummies were identified as having been attendants in the Pharaoh’s palace and belonging to the upper class. The CT examination revealed the presence of aortic and peripheral vascular tissue in 15 of the mummies, and the heart in four of them, three of them with either aortic or peripheral vascular tissue; that is, the cardiovascular system of a total of 16 mummies was found to be still present by CT imaging. Of these 16 evaluable mummies, 5 (31%) had definite atherosclerosis and another 4 (25%) had probable atherosclerosis. Of the 8 mummies older than 45 years at the time of death, 7 (87%) had atherosclerosis, significantly higher than the 2 (25%) mummies younger than 45 years at the time of death; gender analysis revealed that 4 of the 7 female mummies (57%) had atherosclerosis, which was comparable to the prevalence in the male group (56%). The results of this study suggest that atherosclerosis was already present in the middle-aged and elderly of the ancient Egyptian upper class, and was not uncommon. This confirms that atherosclerosis is an ancient disease, not a modern disease that emerged after industrialization, and that genetic susceptibility and environmental factors that contribute to the development of atherosclerosis were already present in ancient humans. In 2013, Thompson RC of the University of Missouri-Kansas City School of Medicine performed the first whole-body CT scans of 137 mummies from 4,000 years in 4 different regions, the only study to date to assess the occurrence of atherosclerosis in pre-industrial populations from 4 different geographic regions. study. The mummies in this study were from ancient Egypt, ancient Peru, the ancestors of the Puebloan people of the American Southwest, and the Aleutian Islands. Of these four groups, the ancient Egyptians and ancient Peruvians were farmers, the ancient Puebloans of Southwest America were pirate farmers, and the Ugandans of the Aleutian Islands were gatherers and hunters. All of these groups were non-vegetarians and manual laborers, with different diets, different climates, geographic distances, and different native plants, which provides a possibility to study the relationship between atherosclerosis and different living environments and different lifestyles. Of the 137 mummies, 47 mummies (34%) were found to have confirmed or suspected atherosclerosis, with the following distribution among the four geographic regions: 29 of 76 mummies (38%) from ancient Egypt had atherosclerosis, 13 of 51 mummies (25%) from ancient Peru had atherosclerosis, and 2 of 5 mummies (40%) from the ancestors of the Puebloan people had atherosclerosis. Atherosclerosis was present in 2 of 5 (40%) mummies from Puebloan ancestors and in 3 of 5 (60%) mummies from the Aleutian Islands. The researchers found atherosclerosis in 28 (20%) mummies in the aorta, 25 (18%) in the iliac or femoral artery, 25 (18%) in the N or tibial artery, 17 (12%) in the carotid artery, 6 (4%) in the coronary artery, and in 34 (25%) of the above five vascular beds, atherosclerosis involved 1-2 vascular beds. In 11 (8%) mummies, atherosclerosis involved 3-4 vascular beds, and only 2 (1%) mummies had involvement of all 5 vascular beds. It was also found that the age at death was positively correlated with atherosclerosis, with a statistically significant difference between the mean age at death of 43 years for mummies with atherosclerosis and 32 years for mummies without atherosclerosis. The mean age at death was also positively correlated with the number of vascular beds involved, with a mean age of 32 years for mummies without atherosclerosis, 42 years for mummies with 1-2 vascular beds involved in atherosclerosis, and 44 years for mummies with 3-5 vascular beds involved in atherosclerosis, all with statistically significant differences. The results of this study clarify for the first time that atherosclerosis was common among ancient human species living in different regions with different lifestyles, diets and genetic backgrounds throughout human history, which may suggest that the occurrence of atherosclerosis is not directly related to lifestyle but rather to the existence of susceptibility factors. Atherosclerosis was also found in ancient Chinese populations The earliest surviving female coronary heart disease corpse in China was excavated from the Mawangdui Han tomb in Changsha, China, in 1972. The patient lived before 2100. Pathological examination confirmed that the lumen of the left coronary artery was more than 3/4 narrowed, and the presence of post-myocardial infarction scar tissue in the apical part of the left ventricle was observed by electron microscopy, which could confirm the presence of severe atherosclerosis in this patient. Atherosclerosis may be a manifestation of human aging, i.e., pathological aging, and is not absolutely due to a specific diet or lifestyle.