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NEW YORK, Dec. 20 (UPI) -- Having high cholesterol and high blood pressure before age 55 has a lasting impact on your risk of heart disease in later life -- even if you subsequently lower your levels, new research indicates. The study was published Wednesday in PLOS One.
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Researchers found a consistent association between exposure to higher low-density lipoprotein -- the "bad" cholesterol -- and systolic blood pressure with increased odds of coronary heart disease in people age 55 or younger, 55 to 60, 61 to 65 and older than 65 years.
Exposure to elevated LDL and blood pressure in early to midlife increased the risk of heart disease independent of later-life LDL and blood pressure levels.
The study's lead author, Dr. Nelson Wang, a research fellow at the George Institute for Global Health and Royal Prince Alfred Hospital in Sydney, told UPI via email that "we undertook this study because we were interested in the impact of elevated cholesterol and blood pressure during young adulthood on coronary disease."
He added: "It is possible that the link between these risk factors and heart disease differs according to stage of life. Therefore, we conducted a study to look at the impact of genetically mediated cholesterol and blood pressure levels on risk of coronary heart disease according to age."
Researchers conducted an analysis from the UK Biobank, including 136,648 participants for LDL cholesterol, 135,431 participants for systolic blood pressure and 24,052 cases of coronary heart disease. They evaluated the effect of duration of exposure to the risk factors on the risk of coronary heart disease stratified by age.
"This study provides further evidence for the cumulative risk factor hypothesis, which suggests that the risk of coronary disease accumulates throughout life and is proportional to the duration of exposure to high blood pressure and cholesterol," Wang said.
"Therefore, we need lifelong risk factor control beginning early in life. This is because elevated blood pressure and cholesterol levels during young adulthood will increase coronary risk later in life, even if risk factors are later well controlled."
Dr. Gordon Huggins, a cardiologist at Tufts Medical Center in Boston, who was not involved in the study, told UPI in a telephone interview that "essentially, you're never too young to start making improvements in your cholesterol and blood pressure because the benefits will be far greater than waiting and then relying on medications."
He added that "the risk of coronary heart disease is dependent upon the cumulative burden of risk including cholesterol and blood pressure across the lifespan."
Increasing evidence suggests that atherosclerosis begins early -- in the teens and 20s, and progresses to variable degrees in the 20s and 30s, Dr. Matthew Tomey, an assistant professor of medicine at the Icahn School of Medicine at Mount Sinai and a cardiologist at Mount Sinai Fuster Heart Hospital in New York, told UPI via email.
"Disease linked to atherosclerosis is the leading cause of death in the United States. About half of Americans between ages 45 and 84 have atherosclerosis and don't know it," Tomey said. "We need to think more about an individual's aggregate exposure to excess LDL cholesterol across the lifespan."
Tomey added: "Imagine if we could do a better job controlling blood pressure and LDL-cholesterol in youth, compounding the rewards of this risk factor control over time. We could decimate incidence of cardiovascular disease, leading to longer, healthier, more active lives on a massive scale."
Dr. James Cireddu, medical director of the University Hospitals of Cleveland Harrington Heart & Vascular Institute in Bedford and Richmond, Ohio, said high blood pressure and high cholesterol "are well established risk factors for coronary artery disease that can be impacted by lifestyle modification, including diet and exercise, as well medical therapy."
"Other important risk factors include advanced age, family history, being male, diabetes mellitus, kidney disease, smoking, obesity and inflammation," said Cireddu, who also is an assistant clinical professor at Case Western Reserve University School of Medicine in Cleveland.
It has been known since the 1950s that high cholesterol and high blood pressure are risk factors for coronary heart disease, Dr. Jeffrey Anderson, an interventional cardiologist and professor of cardiovascular research at Intermountain Health in Salt Lake City, told UPI via email.
As a result, the study's findings are not surprising, Anderson said, adding that this research provides additional evidence to support beginning treatment for high cholesterol and high blood pressure earlier in life, when the 10-year risk of coronary heart disease is still low.
The study "also provides evidence for treatment of older individuals based on cumulative genetic risk over a lifetime rather than simply blood pressure and cholesterol levels at a later age," he said. Both young people and older adults "are relatively undertreated."
