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Are Abnormal Lipid Levels Harmful in Young Adults? FREE

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The summary below is from the full report titled “Nonoptimal Lipids Commonly Present in Young Adults and Coronary Calcium Later in Life: The CARDIA (Coronary Artery Risk Development in Young Adults) Study.” It is in the 3 August 2010 issue of Annals of Internal Medicine (volume 153, pages 137-146). The authors are M.J. Pletcher, K. Bibbins-Domingo, K. Liu, S. Sidney, F. Lin, E. Vittinghoff, and S.B. Hulley.


Ann Intern Med. 2010;153(3):I-25. doi:10.7326/0003-4819-153-3-201008030-00001
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What is the problem and what is known about it so far?

Lipids are fats, such as “good” and “bad” cholesterol or triglycerides, that circulate in the blood as part of normal body metabolism. Abnormal lipid levels may make a person more likely to develop atherosclerosis, a thickening of blood vessel walls that can lead to heart attacks and strokes. People with atherosclerosis sometimes accumulate calcium in their blood vessel walls. A special form of computed tomography (CT) can detect calcium in the blood vessels of the heart (coronary arteries). People with lots of calcium in their coronary arteries are more likely to have heart attacks and strokes. It is well known that abnormal lipid levels in middle age cause calcium to accumulate in coronary arteries and cause heart attacks. However, it is less clear whether abnormal lipid levels at younger ages are harmful, because so few young adults have heart attacks. Showing that abnormal lipid levels in young adulthood contribute to coronary artery calcium would suggest that they are harmful. It would also suggest that younger people need to pay attention to maintaining a healthy lifestyle, even though their short-term risk for a heart attack is low.

Why did the researchers do this particular study?

To see whether young adults with abnormal lipid levels are more likely to have calcium buildup in their coronary arteries later in life.

Who was studied?

3258 young adults who participated in a long-term study of heart health.

How was the study done?

The researchers measured participants' lipid levels over 15 to 20 years. At the end of that period, they did CT to measure coronary artery calcium. They then compared the probability of having coronary artery calcium in participants with and without abnormal lipid levels.

What did the researchers find?

Participants with worse lipid levels throughout young adulthood were more likely to have calcium in their coronary arteries later in life.

What were the limitations of the study?

Not everyone with coronary artery calcium develops heart attacks and other diseases. The findings are therefore suggestive but not definitive. Also, the findings could be caused by factors other than those that the researchers measured.

What are the implications of the study?

Abnormal lipid levels in young adulthood make a person more likely to have coronary artery calcium and atherosclerosis later in life. People aged 20 to 35 years should be aware that what they eat and how much they exercise matter—even though their risk for a heart attack is low in the short term—and should not defer healthy eating and exercise until middle age.

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