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Atherosclerosis in youth.

H C McGill¹, E E Herderick, C A McMahan

¹University of Texas Health Science Center at San Antonio, Southwest Foundation for Biomedical Research, San Antonio, Texas, USA.

Minerva Pediatrica

|September 24, 2002

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Long-range prevention of coronary heart disease (CHD) should start in youth. Key risk factors like high non-HDL cholesterol, hypertension, and obesity are linked to early atherosclerotic lesions in young adults.

Area of Science:

Cardiovascular Medicine
Public Health
Pathology

Background:

Coronary heart disease (CHD) and atherosclerosis remain significant global health issues.
While adult risk factor modification is effective, the optimal age for initiating primary prevention is debated.
Improved treatments exist for end-stage disease, but primary prevention strategies require further investigation.

Purpose of the Study:

To investigate the relationship between adult CHD risk factors and preclinical atherosclerotic lesions in young individuals.
To determine the progression of atherosclerosis with age in both males and females.
To analyze the association of specific risk factors with the development of atherosclerotic lesions.

Main Methods:

The Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study involved 3,000 participants aged 15-34.

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Data included arterial and blood samples, along with risk factor assessments (lipoproteins, smoking, blood glucose, hypertension, obesity).

Central laboratories analyzed atherosclerosis in aorta and coronary arteries, correlating findings with risk factor data.

Main Results:

Raised coronary artery lesions, indicative of advanced atherosclerosis, correlated positively with non-HDL cholesterol, hypertension, obesity (in men), and blood glucose.
High HDL cholesterol concentration showed an inverse association with raised coronary lesions.
Smoking was predominantly linked to atherosclerosis in the abdominal aorta.

Conclusions:

Early intervention for coronary heart disease (CHD) prevention is recommended, starting in adolescence or young adulthood.
Controlling major established risk factors for adult CHD is crucial for long-term primary prevention.
The findings support initiating risk factor management at a younger age to mitigate future cardiovascular disease.