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Low-Density Lipoprotein Cholesterol, Cardiovascular Risk Factors, and Predicted Risk in Young Adults
Alexander R Zheutlin1, Samuel Luebbe1, Alexander Chaitoff2
1Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Insights
In young adults, higher LDL-C levels correlate with more non-LDL-C cardiovascular disease (CVD) risk factors. Both LDL-C and other risk factors independently increase long-term CVD risk, highlighting a need for better management strategies.
Area of Science:
- Cardiology
- Preventive Medicine
- Public Health
Background:
- Young adults with elevated LDL-C often have co-occurring CVD risk factors.
- The correlation between LDL-C and non-LDL-C risk factors in young adults is not well understood.
- Understanding these associations is crucial for predicting long-term cardiovascular disease (CVD) risk.
Purpose of the Study:
- To quantify the clustering of non-LDL-C CVD risk factors based on LDL-C levels in young adults.
- To assess the association between LDL-C, non-LDL-C risk factors, and predicted CVD risk.
- To inform strategies for managing cardiovascular risk in younger populations.
Main Methods:
- Cross-sectional analysis of adults under 40 with LDL-C < 190 mg/dL from NHANES (2015-2020).
- Prevalence of non-LDL-C risk factors was measured across different LDL-C categories.
- Association with 30-year CVD risk was evaluated using the PREVENT equations.
Main Results:
- 15.5% of young adults had LDL-C ≥ 130 mg/dL.
- Higher LDL-C levels were associated with a greater number of non-LDL-C risk factors.
- Both LDL-C and non-LDL-C factors independently predicted 30-year CVD risk (ORs 1.05 and 1.17, respectively).
Conclusions:
- Non-LDL-C risk factors tend to cluster with increasing LDL-C levels in young adults.
- Both LDL-C and non-LDL-C risk factors contribute independently to long-term CVD risk.
- Enhanced guidance is needed for managing cardiovascular risk factors in young adults.
Background:
Young adults with elevated LDL-C may experience increased burden of additional cardiovascular disease (CVD) risk factors. It is unclear how much LDL-C levels, a modifiable factor, correlate with non-LDL-C CVD risk factors among young adults or how strongly these CVD risk factors are associated with long-term predicted CVD risk. We quantified clustering of non-LDL-C CVD risk factors by LDL-C among young adults to assess the association between non-LDL-C and LDL-C risk factors with predicted CVD risk in young adults.
Methods:
The current analysis is a cross-sectional study of adults < 40 years with an LDL-C< 190 mg/dL participating in the National Health and Nutrition Examination Survey (NHANES) between January 2015 and March 2020. We measured the prevalence of non-LDL-C risk factors by LDL-C and association between LDL-C and non-LDL-C risk factors with predicted risk of CVD by the Predicting Risk of cardiovascular disease EVENTs (PREVENT) equations.
Results:
Among 2108 young adults, the prevalence of LDL-C ≥ 130 mg/dL was 15.5%. Compared with young adults with LDL-C < 100 mg/dL, those with LDL-C 100-< 130, 130-< 160, and 160-< 190 mg/dL had greater non-LDL-C risk factors. Both LDL-C and non-LDL-C risk factors were independently associated with a 30-year risk of CVD (OR 1.05, 95% CI 1.03-1.07 and OR 1.17, 95% CI 1.12-1.23, respectively). The association of LDL-C and 30-year risk did not vary by non-LDL-C risk factor burden (pinteraction = 0.43).
Conclusion:
Non-LDL-C risk factors cluster among increasing levels of LDL-C in young adults. Greater guidance on how to manage cardiovascular risk factors in young adults is needed.
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