Act sooner rather than later to prevent heart disease, a new study suggests. This means young adults should not put off treating high blood pressure or unhealthy cholesterol levels.
The study involved more than 36,000 Americans. It came to some sobering conclusions about young adults with high blood pressure or elevated LDL cholesterol (the "bad" kind): They may face increased risks of heart disease years later -- even if they manage to get those numbers down in middle-age.
Researchers said the findings suggest that young people, and their doctors, need to take blood pressure and cholesterol more seriously.
"Young adults can perceive themselves as invincible," said senior researcher Dr. Andrew Moran. "They often think they can wait until they're older to make changes."
But his team found that when people younger than 40 had higher-than-normal LDL cholesterol (100 mg/dL and up), it spelled trouble ahead. Their risk of eventually developing coronary heart disease was 64% higher, versus their peers with healthier LDL (or low-density lipoprotein cholesterol) levels.
And that was true regardless of their LDL numbers in middle-age.
Coronary heart disease is caused by a buildup of "plaques" in the arteries, and high LDL cholesterol is one of the main contributors.
The picture was similar with blood pressure. When adults younger than 40 had high blood pressure, they were 21 percent to 37 percent more likely to develop heart failure years down the road.
Heart failure is a chronic condition in which the heart muscle gradually weakens and loses its ability to pump blood efficiently. High blood pressure is one of the major risk factors.
"This shows that the young-adult years are important, especially when it comes to cholesterol," said Moran, an associate professor at Columbia University Medical Center, in New York City.
Dr. Samuel Gidding, medical director of the FH (Familial Hypercholesterolemia) Foundation, agreed.
"If you have risk factors, addressing them will help you live longer," said Gidding, who co-wrote an editorial published with the study.
Lifestyle changes are key to managing LDL and blood pressure, Moran said. That means a healthy diet, regular exercise, weight loss if necessary, and not smoking. Depending on how high the numbers are, medication may be needed.
Gidding said that medication is underused in younger people. Based on research, he said, less than one-third of Americans under 50 who are eligible for high blood pressure medication actually get it.
The new findings were published online July 15 in the Journal of the American College of Cardiology. The results were based on six previous studies of U.S. adults. In all, the study included more than 36,000 people who were typically followed for 17 years. During that time, nearly 9,700 people developed heart disease, and nearly 2,900 suffered a stroke.
Most of the studies did not include younger adults. So the researchers estimated those participants' early adulthood blood pressure and LDL levels by using data from the studies that did involve young adults, along with statistical modeling.
In general, Moran's team found, high blood pressure or high LDL before age 40 spelled a higher risk of heart trouble down the road -- even with factors like smoking, weight and diabetes taken into account.
And the connection was seen regardless of people's blood pressure and LDL levels later in life.
The findings on stroke were different: Young adults' blood pressure and LDL numbers were not independent risk factors. But high blood pressure after age 40 was a major contributor to stroke risk.
So the bottom line, according to Moran, is that adults of all ages should care about their blood pressure and cholesterol numbers.
"Don't wait to make lifestyle changes," he said. "The choices you make now matter in the long term."
But even though young adulthood matters, that does not imply it's ever too late for older adults to make changes for the better.
"That would be a misperception," Moran said.
Gidding agreed that "older adults still benefit from treatment. That's what all the clinical trials show us."
The study was funded by the U.S. National Institutes of Health.
The U.S. National Heart, Lung, and Blood Institute has a guide on heart disease prevention.
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