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July 28, 2010

Half of young adults have CHD risk factors

From Theheart.org, 22 July 2010

Atlanta, GA Approximately half of young adults have at least one cardiovascular disease risk factor, such as a family history of disease, smoking, hypertension, or obesity, according to the results of a new study [1]. An assessment of blood cholesterol levels, however, remains low in this population, and less than 50%, irrespective of cardiovascular risk status, are screened for high cholesterol levels, report researchers.

“Because the severity of atherosclerosis in young adults increases with the number of risk factors, the low screening rates, particularly among young persons with two or more risk factors, are of concern,” write lead author Dr Elena Kuklina (Centers for Disease Control, Atlanta, GA) and colleagues in the July/August 2010 issue of the Annals of Family Medicine.

The data are from an analysis of 2587 young adults—men aged 20 to 35 years and women aged 20 to 45 years—included in the 1999-2006 National Health and Nutrition Examination Surveys.

Overall, 55.2% of men and women had at least one cardiovascular disease risk factor; 17.9% had two risk factors. Of these men and women, 4.6% had CHD or a CHD risk equivalent. Regarding screening, less than 50% of people were screened for elevated cholesterol levels, although it was higher among women than men. Among those with CHD or a CHD risk equivalent, however, just 67% of young adults were screened for elevated cholesterol; 47% of adults with two or more risk factors were screened.

Among young adults, the prevalence of high cholesterol levels increased with the number of CHD risk factors—65% of those with CHD/CHD risk equivalent had high LDL-cholesterol levels, compared with 6.7% of those without any risk factors—but the screening rate was less than 50% regardless of risk status. Also, there was no statistically significant difference in screening rates among those with no risk factors and those with one or more risk factors.

“Our results indicate that improvement of risk assessment and management for cardiovascular disease among young adults through evidence-based clinical and public-health interventions is warranted,” conclude the authors.

Source

  1. Kuklina EV, Yoon PW, Keenan NL. Prevalence of coronary heart disease risk factors and screening for high cholesterol levels among young adults, United States, 1999-2006. Ann Fam Med 2010; 8:327-333. 

COMMENTARY by G. Szto:

Young adults are usually fairly unconcerned about their health. They think that they are immune to chronic health problems like coronary artery disease (CAD). Atherosclerosis (deposition of cholesterol along the linings of arteries) occurs very slowly – usually over decades. Autopsies of young American soldiers during the Vietnam war showed that they were already displaying early cholesterol streaks in their blood vessels. Blockages in arteries do not result in symptoms until they are more than 70% blocked. Hence, we hear frequently of people who were well one day, but died suddenly of a fatal heart attack. These people would have been identified, if they had gone to seek help to look for silent heart disease – to this end a Multi-slice Cardiac CT scan is of paramount importance in detecting asymptomatic coronary artery disease. In addition to simple bllod pressure checks and blood test looking at blood sugar and cholesterol, please look at my website section on Multislice Cardiac CT scanning for more information….