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Summaries for Patients |20 June 2017

Prevalence of Elevated Cardiovascular Risks in Young Adults Free

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Author, Article, and Disclosure Information
This article was published at Annals.org on 16 May 2017.

  • The full report is titled “Prevalence of Elevated Cardiovascular Risks in Young Adults: A Cross-sectional Analysis of National Health and Nutrition Examination Surveys.” The authors are K.K. Patel, G.B. Taksler, B. Hu, and M.B. Rothberg.


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    • What is the problem and what is known about it so far?
    • Why did the researchers do this particular study?
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What is the problem and what is known about it so far?

Recent guidelines make different recommendations about when to begin cholesterol screening in adults. One guideline recommends screening adults older than 20 years, whereas another recommends screening men older than 35 and women older than 45 years. How many adults younger than 50 years have increased risks for heart disease is unclear. Understanding how the risk for heart disease differs by age may help physicians to better target cholesterol screening.

Why did the researchers do this particular study?

To describe the groups of adults younger than 50 years in the U.S. population who have an increased risk for heart disease on the basis of their age, sex, and smoking status and whether they have high blood pressure. Having this information may help doctors understand the groups of young adults for whom cholesterol screening may or may not be useful.

Who was studied?

9608 adults aged 30 to 49 years who did not have a history of heart disease, stroke, or diabetes.

How was the study done?

The researchers analyzed information on adult participants in the NHANES (National Health and Nutrition Examination Survey) from 1999 to 2000 through 2011 to 2012, who answered questions about their medical history and medications. The participants had a physical examination and laboratory tests, including different cholesterol measurements (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol [LDL-C], and triglycerides). The researchers used a calculator to identify adults with an increased 10-year risk for heart disease.

What did the researchers find?

Overall, 10% of the young adults (or 10 in 100) had an increased 10-year risk for heart disease, mainly those who had risk factors of smoking and high blood pressure. For men younger than 40 years who did not smoke or have high blood pressure, a very small proportion (<1 in 100) had a high risk for heart disease. The same was found for women younger than 50 years who did not smoke or have high blood pressure. These low-risk subgroups accounted for about half of the young adult population in the United States. Only 3% (or 3 in 100 people) had a very high level of LDL-C (“bad cholesterol”). They were no more likely to have a family history of heart disease than the adults without an increased LDL-C level.

What were the limitations of the study?

The study measured estimated risks for heart disease, not the actual number of patients who developed heart disease.

What are the implications of the study?

Screening for cholesterol may not be useful in men younger than 40 and women younger than 50 years who do not have risk factors for heart disease, such as high blood pressure and smoking.

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Prevalence of Elevated Cardiovascular Risks in Young Adults. Ann Intern Med. 2017;166:I–24. [Epub ahead of print 16 May 2017]. doi: https://doi.org/10.7326/P17-9037

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Published: Ann Intern Med. 2017;166(12):I-24.

DOI: 10.7326/P17-9037

Published at www.annals.org on 16 May 2017

©
2017 American College of Physicians
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