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 The analysis pooled data from six studies involving a total of
36,030 people. Starting when participants were 53 years old on
average, researchers tracked them to see who had heart attacks,
strokes, or heart failure.
By the time half of the people had been tracked for at least 17
years, participants who had high levels of "bad" LDL cholesterol
before age 40 - that is, higher than about 129 milligrams per
deciliter of blood - were 64% more likely to have had events like
heart attacks compared to people with low LDL levels in early
adulthood.
The upper limit of normal blood pressure is 120/80. Younger adults
who had high systolic blood pressure - the "top number" - were 37%
more likely to develop heart failure later in life. And young adults
who had elevated diastolic blood pressure - the "bottom number" -
were 21% more likely to develop heart failure later on.
"Many young adults feel OK, or they're willing to think--I'm OK now,
I will make healthful choices later when I'm older," said Dr. Andrew
Moran, senior author of the study and a researcher at Columbia
University Medical Center in New York City.
"This study shows that healthy choices matter even in young adults,"
Moran said by email. "This means not smoking, eating a healthful
diet, and exercising regularly."
And for some high risk young adults, starting medication to manage
risk factors at a younger age - something that currently isn't done
as a matter of course - may be worthwhile, Moran added.
Very few people in the study had high blood pressure or high
cholesterol during young adulthood, researchers report in the
Journal of the American College of Cardiology.
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During follow-up, 4,570 participants had events like heart attacks,
5,119 had heart failure events, and 2,862 had strokes.
The study can't explain whether or how high blood pressure or
elevated cholesterol in early adulthood might directly cause heart
attacks, strokes or heart failure later in life.
One limitation of the analysis is that because the smaller studies
used in the analysis didn't have blood pressure and cholesterol
measurements across the lifespan, in some cases researchers had to
estimate how many younger adults had these risk factors based on the
data they had for participants at older ages.
"Heart failure and heart attacks are the result of years of exposure
to risk factors like high blood pressure and cholesterol," said Dr.
Samuel Gidding, coauthor of an editorial accompanying the study and
medical director of the FH (Familial Hypercholesterolemia)
Foundation in Pasadena, California.
"Both cause the buildup of fat in the coronary arteries beginning in
childhood; this leads to heart attack later in life," Gidding said
by email. "High blood pressure puts extra strain on the heart and
adapting to that stress leads to heart failure."
SOURCE: http://bit.ly/2lnLSoy and http://bit.ly/2lsFzjD Journal of
the American College of Cardiology, online July 15, 2019.
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