In the Journals

Elevated BP, LDL in young adults increase risk for CV events later in life

Jennifer Robinson
Jennifer Robinson

Young adults with elevated systolic BP, diastolic BP and LDL had an increased risk for CVD later in life regardless of exposures later in adulthood, according to a study published in the Journal of the American College of Cardiology.

“Our results add to accumulating evidence that young adulthood is a critical period when exposure to suboptimal BP or cholesterol is particularly harmful, and maintaining optimal levels of BP and LDL throughout young adulthood could yield substantial lifetime CVD prevention benefits,” Yiyi Zhang, PhD, associate research scientist and principal investigator in the division of general medicine at Columbia University, and colleagues wrote. “However, young adults are difficult to reach by way of traditional, clinic-based preventive programs.”

Researchers analyzed data from 36,030 participants (mean age, 53 years; 45% men) without CVD at baseline from six large cohort studies: ARIC, CARDIA, the Cardiovascular Health Study, Framingham Heart Study Offspring Cohort, MESA and the Health ABC study. Several primary CVD risk factors were assessed including LDL, HDL, systolic BP and diastolic BP.

The primary outcomes of interest were incident CHD, stroke and HF. Participants were followed up for a median of 17 years.

During follow-up, there were 4,570 incident CHD events, 2,862 strokes and 5,119 HF events.

Young adults with an LDL greater than 100 mg/dL had an increased risk for CHD compared with those with an LDL less than 100 mg/dL (HR = 1.64; 95% CI, 1.27-2.11).

Young adults with elevated systolic BP, diastolic BP and LDL had an increased risk for CVD later in life regardless of exposures later in adulthood, according to a study published in the Journal of the American College of Cardiology.
Source: Adobe Stock

Compared with young adults with a systolic BP less than 120 mm Hg, those with a systolic BP greater than 130 mm Hg had an increased risk for HF (HR = 1.37; 95% CI, 1.17-1.61). Young adults with a diastolic BP greater than 80 mm Hg also had an increased risk for stroke (HR = 1.21; 95% CI, 1.04-1.41).

“Interventions in those with established ASCVD, advanced subclinical atherosclerosis, impaired myocardial function, diabetes or renal insufficiency are disease treatment studies and not true prevention,” Samuel S. Gidding, MD, chief medical officer of the Familial Hypercholesterolemia Foundation, and Jennifer Robinson, MD, MPH, professor and director of the Preventive Intervention Center at the University of Iowa College of Public Health in Iowa City, wrote in a related editorial. “By moving to trials in younger higher-risk individuals who have less advanced disease more amenable to reversal, and developing precision medicine strategies based on genetics, imaging and other risk factors, the next era of cardiovascular disease prevention can begin.” – by Darlene Dobkowski

Disclosures: Zhang and Gidding report no relevant financial disclosures. Robinson reports she received research grants to her institution from Acasti, Amarin, Amgen, AstraZeneca, Esai, Esperion, Merck, Pfizer, Regeneron, Sanofi and Takeda and served as a consultant for Amgen, Merck, Novartis, Novo Nordisk, Pfizer, Regeneron and Sanofi. Please see the study for all other authors’ relevant financial disclosures.

Jennifer Robinson
Jennifer Robinson

Young adults with elevated systolic BP, diastolic BP and LDL had an increased risk for CVD later in life regardless of exposures later in adulthood, according to a study published in the Journal of the American College of Cardiology.

“Our results add to accumulating evidence that young adulthood is a critical period when exposure to suboptimal BP or cholesterol is particularly harmful, and maintaining optimal levels of BP and LDL throughout young adulthood could yield substantial lifetime CVD prevention benefits,” Yiyi Zhang, PhD, associate research scientist and principal investigator in the division of general medicine at Columbia University, and colleagues wrote. “However, young adults are difficult to reach by way of traditional, clinic-based preventive programs.”

Researchers analyzed data from 36,030 participants (mean age, 53 years; 45% men) without CVD at baseline from six large cohort studies: ARIC, CARDIA, the Cardiovascular Health Study, Framingham Heart Study Offspring Cohort, MESA and the Health ABC study. Several primary CVD risk factors were assessed including LDL, HDL, systolic BP and diastolic BP.

The primary outcomes of interest were incident CHD, stroke and HF. Participants were followed up for a median of 17 years.

During follow-up, there were 4,570 incident CHD events, 2,862 strokes and 5,119 HF events.

Young adults with an LDL greater than 100 mg/dL had an increased risk for CHD compared with those with an LDL less than 100 mg/dL (HR = 1.64; 95% CI, 1.27-2.11).

Young adults with elevated systolic BP, diastolic BP and LDL had an increased risk for CVD later in life regardless of exposures later in adulthood, according to a study published in the Journal of the American College of Cardiology.
Source: Adobe Stock

Compared with young adults with a systolic BP less than 120 mm Hg, those with a systolic BP greater than 130 mm Hg had an increased risk for HF (HR = 1.37; 95% CI, 1.17-1.61). Young adults with a diastolic BP greater than 80 mm Hg also had an increased risk for stroke (HR = 1.21; 95% CI, 1.04-1.41).

“Interventions in those with established ASCVD, advanced subclinical atherosclerosis, impaired myocardial function, diabetes or renal insufficiency are disease treatment studies and not true prevention,” Samuel S. Gidding, MD, chief medical officer of the Familial Hypercholesterolemia Foundation, and Jennifer Robinson, MD, MPH, professor and director of the Preventive Intervention Center at the University of Iowa College of Public Health in Iowa City, wrote in a related editorial. “By moving to trials in younger higher-risk individuals who have less advanced disease more amenable to reversal, and developing precision medicine strategies based on genetics, imaging and other risk factors, the next era of cardiovascular disease prevention can begin.” – by Darlene Dobkowski

Disclosures: Zhang and Gidding report no relevant financial disclosures. Robinson reports she received research grants to her institution from Acasti, Amarin, Amgen, AstraZeneca, Esai, Esperion, Merck, Pfizer, Regeneron, Sanofi and Takeda and served as a consultant for Amgen, Merck, Novartis, Novo Nordisk, Pfizer, Regeneron and Sanofi. Please see the study for all other authors’ relevant financial disclosures.