High Cholesterol in Young Adulthood Heightens CHD Risk

Benefits of Extended-Release Niacin Questionable
Benefits of Extended-Release Niacin Questionable
Young adults with high cholesterol have an increased risk for developing coronary heart disease later in life.

For every 10 years that a patient has mild to moderately elevated cholesterol between ages 35 and 55 years, the risk for coronary heart disease (CHD) later in life may increase by nearly 40%, according to new data published in Circulation.

“Our findings suggest that [adults with longstanding mild to moderately elevated cholesterol levels] may benefit from more aggressive prevention strategies earlier,” study researcher Ann Marie Navar-Boggan, MD, PhD, cardiology fellow at the Duke Clinical Research Institute in Durham, North Carolina, said in a press release.

Dr. Navar-Boggan and colleagues evaluated data from the Framingham Offspring Cohort study on adults without cardiovascular disease (CVD) at age 55 years (n=1,478). They then investigated the link between duration of moderate hyperlipidemia, defined as non-HDL of 160 mg/dL or greater, in early adulthood and later development of CHD.

Of those included in the study, 389 participants had experienced 1 to 10 years of hyperlipidemia, 577 had experienced 11 to 20 years of hyperlipidemia and 512 did not have high cholesterol, according to the data.

At a median follow-up of 15 years, results revealed significantly higher rates of CHD among adults with prolonged exposure to hyperlipidemia, which appeared to increase with longer duration. Risk for CHD was 4.4% for those with no exposure, 8.1% for those with 1 to 10 years of exposure and 16.5% for those with 11 to 20 years of exposure (P<.001).

The association remained even after adjustment for other risk factors, including non-HDL at age 55 years (HR=1.39; 95% CI, 1.05-1.85 per decade of hyperlipidemia).

Further, the researchers noted that, under current national guidelines, 85% of young adults with prolonged hyperlipidemia would not have been recommended for statin therapy at age 40 years. Nevertheless, among those not considered for statin therapy at age 55 years, a significant link between cumulative exposure to hyperlipidemia in young adulthood and subsequent CHD risk persisted (adjusted HR=1.67; 95% CI, 1.06-2.64).

“… Not every 35-year-old with mild to moderately elevated cholesterol needs to start statin therapy,” Dr. Navar-Boggan said, but pointed out that young adults with hyperlipidemia should be aware of their increased risk for CVD.

“It’s never too soon for young adults to talk with their doctors about heart health, which should include how to manage cholesterol levels through diet and exercise, and, in certain cases, medication,” Dr. Navar-Boggan said.

“The plaques in arteries that break off and cause heart attacks later in life take years to develop. What is happening in your blood vessels, in particular your cholesterol levels, during your 30s and 40s affects your heart health in your 50s, 60s and 70s,” Dr. Navar-Boggan added.


  1. Navar-Boggan A et al. Circulation. 2015;doi:10.1161/CIRCULATIONAHA.114.012477.