My mistake - they did more than surmise:
Given that Ötzi wasn't overweight, didn't smoke tobacco, regularly exercised and likely didn't have a high-fat diet (at least by today's standards), it appears that his genes — and not his daily routine — explained his health condition.
"I suspect that lifestyle didn't play a major role in his development of plaque," Dr. Philip Green, an interventional cardiologist at New York-Presbyterian who wasn't involved with the study, told Live Science. Despite the suggestion that Ötzi go vegetarian, Zink sees it another way. "Compared to modern standards, he would not be considered as a risk patient," Zink told Live Science. "So, I think a different diet, such as vegetarian or vegan, wouldn’t have helped Ötzi."
There is no doubt Ötzi is one of the oldest cases of vascular calcification, and "a medical example showing that a genetic predisposition is probably the most important trigger factor for arteriosclerosis and coronary heart disease," study co-researcher Patrizia Pernter, a radiologist at Bozen-Bolzano, said in a statement. (From:
https://www.livescience.com/62689-otzi-iceman-mummy-heart-disease.html )
Ötzi the Iceman hardly seems the type to have been prone to heart disease. He died violently around 3300 B.C., aged approximately 40 or 50, and his mummified body was found high in the Italian Alps in 1991. He led a vigorous life, ate a balanced diet, and had no access to tobacco. But when researchers put his remains in a CT scanner, they found calcium deposits in a number of his arteries, indicating the beginnings of atherosclerosis, which commonly leads to heart disease. “By the time Ötzi was 80, he would have had a very good chance of having a heart attack or a stroke,” says Gregory Thomas, a cardiologist at Long Beach Memorial Medical Center in California. (From
https://www.archaeology.org/issues/153-1411/trenches/2608-trenches-mummies-heart-disease )
In the new study, Zink and his colleagues found that Ötzi had several gene variants associated with cardiovascular disease, including one on the ninth chromosome that is strongly tied to heart troubles, the researchers reported today (July 30) in the journal Global Heart.
Despite spending years hiking in hilly terrain, it seems Ötzi couldn't walk off his genetic predisposition to heart disease.
"He didn't smoke; he was very active; he walked a lot; he was not obese," Zink said. "But nevertheless, he already developed some atherosclerosis." (From:
https://www.livescience.com/47114-otzi-had-heart-disease-genes.html )
In particular, the genetic sequencing data demonstrates that the Iceman had a very specific genetic mutation, namely that he was homozygous for the minor allele (GG) of rs10757274, located in chromosomal region 9p21. This SNP is currently regarded as being among the strongest genetic predictors of heart attacks and has been confirmed in several studies as a major risk locus for CHD. (From
https://www.sciencedaily.com/releases/2014/07/140730203707.htm )