Advanced coronary atherosclerosis was angiographically demonstrated in 21 women aged 40 years or younger. To facilitate the recognition of women susceptible to coronary atherosclerosis from those with chest pain of other cause, the patients' conditions were investigated with regard to various easily identifiable atherogenic risk factors. Eighty-six percent of the patients had at least three of five predisposing factors: family history (of coronary artery disease, hypertension, or diabetes mellitus), hypertension, hyperlipidemia, glucose intolerance, and cigarette smoking. Only three of the 21 patients were free of both hypertension and elevated serum cholesterol levels. Obesity and hyperuricemia were not found to improve the predictive yield. Data on pregnancies, menstruation, oophorectomies, and estrogen therapy did not afford clues regarding the cause of precocious coronary atherosclerosis in these young women.
(JAMA 230:1531-1534, 1974)