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Managing cholesterol in young adults may pay off later in life

By Stephen Feller

SAN FRANCISCO, June 8 (UPI) -- Treating high cholesterol in young adults could help prevent heart attacks and heart disease later in life, a recent study suggests.

Researchers at the University of California San Francisco and Columbia University report proactive treatment of high cholesterol in people closer to age 20 the same way high blood pressure is treated could stave off heart conditions as they age.

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Although the researchers used data collected during the last 50 years to model the potential for coronary heart disease in young adults with high blood pressure and high cholesterol, they said they are unsure of the exact role the risk factors play in the condition's development -- and they are unsure whether treatments could work.

Using statin drugs to reduce cholesterol in people close to age 20 is currently only recommended if their health indicates a medium-term, or ten-year, risk for cardiovascular disease or coronary heart disease is greater than 7.5 percent.

With a lack of evidence to base the decisions on, the researchers say it is unknown what the effect of the drugs will be on disease risk.

"There will be hard decisions to make regarding statin therapy for young adults," Dr. Mark Pletcher, a professor at the University of California San Francisco, said in a press release. "Without evidence of effectiveness from randomized trials, we need to talk through the sometimes-unknown risks and benefits of early treatment of high cholesterol with our patients and engage in shared decision-making on this issue."

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For the study, published in the journal PLOS One, researchers analyzed data on 4,860 people participating in the Framingham Offspring Study since 1971, an ongoing cohort tracking the children of participants in the original Framingham Heart Study.

At the end of the most recent follow-up period, 35 percent of participants were being treated with blood pressure medications and 14 percent were on medications for cholesterol, and 510 participants had some type of coronary heart disease event during the follow-up period.

The unadjusted event rates for participants were 8 to 30 times higher in participants with high blood pressure and high cholesterol between the age of 20 and 39 when compared to those who had normal levels of exposure to the risk factors.

Although the researchers say there is a lack of evidence statins will help younger people with high cholesterol avoid disease, and more studies with other populations need to be conducted to confirm the link, the data in the recent study suggests doctors consider treatment of high cholesterol at younger ages than they normally would.

"Our study implies that current guidelines may not be ideal and that it might make sense to treat young adults with high cholesterol in order to prevent heart attacks later in life," Pletcher said. "It's hard to actually prove that this approach would work, though, because it would take 20 to 30 years to follow young adults into middle age and beyond to see if early adult treatment helps prevent events later in life."

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