Yater’s study of coronary heart disease in young men

Wallace Yater, civilian consultant to the Army Institute of Pathology, and Aaron Traum, former chief of cardiovascular research for the Veterans Administration, collected this prodigious case series of coronary (CHD) cases prior to age 40 and attempted comparisons with an undefined control group designated for the survivors and with men dead of gunshot wounds for those who died of coronary events. Their serial article appeared in three issues of the American Heart Journal at the very moment of birth of formal CVD epidemiology, 1948 (Yater et al 1948). In it they summarized the history of recognition of manifest coronary disease and produced a chart and bibliography of 162 reports in the literature about coronary events in the young.

In a summary of potential causal factors among the young cases (20:1 men:women) they found few significant differences compared to the so-called controls: only a tendency to stronger family history of CHD, to heavier smoking, entry hypertension, anxious personality, and Caucasian ethnicity. There were no differences in body mass or obesity at entry to the service or weight gain later, or in eating patterns, occupational activity, geography or season of the year.

The article was encyclopedic in description of symptoms, signs, electrocardiographic findings, and pathology, with even an attempt to estimate incidence from the collected cases. More than 80 % of those who died, died in the first 24 hours after onset. Most who died had left anterior descending coronary artery occlusion and most had thrombi. Their review embraced the 100 young cases collected by Paul White and reported in 1937 (Glendy et al. 1937). (Henry Blackburn)

References

Glendy, RE, SA Levine, PD White. 1937. Coronary disease in youth. Comparison of 100 patients under 40 with 300 persons past 80. J.A.M.A. 109: 1775.

Yater, WM, AH Traum, WG Brown, RP Fitzgerald, MA Geisler, BB Wilcox. 1948. Coronary artery disease in men 18-39 years of age. Report of 866 cases, 450 with necropsy examination. American Heart Journal 36: 334-372; 481-526; 683-722.