Relatively young individuals with slightly abnormal cholesterol levels have a real risk of developing signs of heart disease by the time they are 45 years old, according to a new study published in the peer-reviewed medical journal Annals of Internal Medicine.

In a 20-year study, researchers gathered data on 3,258 males and females between the ages of 18 and 30 years. They found that even with slightly abnormal cholesterol levels, individuals had a significant risk of developing signs of heart disease before the age of 45.

Cholesterol is a fat (lipid) which is produced by the liver and is crucial for normal body functioning. Cholesterol exists in the outer layer of every cell in our body and has many functions. It is a waxy steroid and is transported in the blood plasma of all animals. It is the main sterol synthesized by animals (including humans).

The main factor driving heart disease risk is low density lipoprotein (LDL), also known as bad colesterol levels. The researchers found that individuals with higher LDL levels were at greater risk of accumulation of calcium in the coronary arteries – a strong predictor of heart disease.

Lead author, Mark Pletcher explained that exposure to higher-than-normal LDL during young adulthood (and even childhood) really does matter when it comes to heart disease risk at middle age – the damage persists until then.

The researchers’ findings regarding arthrosclerosis are consistent with previous study results. Atherosclerosis is the narrowing of arteries caused by an accumulation of fatty deposits. The scientists report that atherosclerosis starts early in life, in some cases when the individual is a child.

The authors stressed early prevention studies are vital for lifelong heart health.

Unfortunately, according to Pletcher, modest rises in LDL levels are frequently ignored by young patients and their doctors.

In this latest study the cholesterol levels of the participants were measured seven times over a period of 20 years. When they reached 45 calcium levels in their coronary arteries were measured, using imaging tests.

The study revealed that:

  • 44% of those with LDL levels over 160 (high) had calcium accumulation in their coronary arteries.
  • Those with high LDL levels were 5.6 times more likely to have calcium build up in their arteries, compared to those with LDL levels below 70 (low).
  • Individuals with LDL levels between 100 and 129 (borderline LDL) were 2.4 times as likely to have calcium accumulation in their coronary arteries compared to those with the lowest LDL levels.

In most countries, LDL levels are considered as good if they are below 100.

The authors concluded:

Nonoptimal levels of LDL and HDL cholesterol during young adulthood are independently associated with coronary atherosclerosis 2 decades later.

  • Atherosclerosis – narrowing of the arteries.
  • Higher coronary heart disease risk – an abnormality of the arteries that supply blood and oxygen to the heart.
  • Heart attack – occurs when the supply of blood and oxygen to an area of heart muscle is blocked, usually by a clot in a coronary artery. This causes your heart muscle to die.
  • Angina – chest pain or discomfort that occurs when your heart muscle does not get enough blood.
  • Other cardiovascular conditions – diseases of the heart and blood vessels.
  • Stroke and mini-stroke – occurs when a blood clot blocks an artery or vein, interrupting the flow to an area of the brain. Can also occur when a blood vessel breaks. Brain cells begin to die.

“Nonoptimal Lipids Commonly Present in Young Adults and Coronary Calcium Later in Life: The CARDIA (Coronary Artery Risk Development in Young Adults) Study”
Mark J. Pletcher, MD, MPH, Kirsten Bibbins-Domingo, PhD, MD, Kiang Liu, PhD, Steve Sidney, MD, MPH, Feng Lin, MS, Eric Vittinghoff, PhD, Stephen B. Hulley, MD, MPH
ANN INTERN MED August 3, 2010 153:202-203

Written by Christian Nordqvist