Good Cholesterol Now, Big Health Payoff Later

High cholesterol in younger adults may increase risk of heart disease later in life

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Cholesterol might not be a hot topic for younger adults, but paying attention to your cholesterol levels early might just save your life later.

High cholesterol levels in early adulthood may increase the risk of coronary heart disease later in life, a new study found. These effects were cumulative, and longer amounts of time with high cholesterol caused a greater risk.

Keeping cholesterol in check from an early age may benefit many patients' health, the authors of this study said.

"What is happening in your blood vessels, in particular your cholesterol levels, during your 30's and 40's affects your heart health in your 50's, 60's and 70's," said lead study author Ann M. Navar-Boggan, MD, PhD, of the Duke Clinical Research Institute in Durham, NC, in a press release.

Dr. Navar-Boggan likened it to the way smoking can increase the risk of heart disease.

"The number of years with elevated cholesterol, or 'lipid years,' can affect you in a similar way to the number of 'pack years' you have had as a smoker," she said. "It shows that what we're doing to our blood vessels in our 20s, 30s and 40s is laying the foundation for disease that will present itself later in our lives."

Cholesterol is a type of fat found in the body. It is necessary for cell membranes and for making certain hormones. Cholesterol is often broken down into two types based on the carrier it is attached to: high-density lipoprotein (HDL, or "good" cholesterol) and low-density lipoprotein (LDL, or "bad" cholesterol).

In high amounts, LDL cholesterol can turn into plaque and clog blood vessels. This can lead to coronary heart disease and a heart attack.

Dr. Navar-Boggan and team studied the Framingham Cohort, a group of patients that has been studied since 1948.

This study included nearly 1,500 patients who were free of heart disease at age 55. Of these, some had normal cholesterol, some had 1 to 10 years of high cholesterol and some had 11 to 20 years of high cholesterol.

Dr. Navar-Boggan and colleagues studied these patients for 15 years. They found that patients with longer exposure to high cholesterol during their 30s and 40s had higher rates of heart disease later in life.

The patients with 11 to 20 years of high cholesterol during their younger adulthood had a 16.5 percent risk of developing coronary heart disease. Those with 1 to 10 years had an 8.1 percent risk. Those with no high cholesterol had only a 4.4 percent risk.

In other words, for every 10 years of exposure to high cholesterol, the risk of heart disease doubled.

Only 15 percent of the most at-risk group would have qualified for statin treatment at age 40. Statins are the most common type of medication for lowering cholesterol.

Because this study found that long-term exposure to high cholesterol was dangerous, Dr. Navar-Boggan and team wondered whether earlier treatment would have helped this group.

"Our findings suggest that they may benefit from more aggressive prevention strategies earlier," Dr. Navar-Boggan said.

This study was published online Jan. 26 in the journal Circulation.

The Duke Clinical Research Institute and the Agency for Healthcare Research and Quality funded this research. Study author Dr. Eric Peterson received grants from Eli Lilly and Janssen Pharmaceuticals and also served on boards for Merck, Sanofi-Aventis, Janssen and Boehringer Ingelheim. Study author Dr. Michael J. Pencina consulted for AbbVie.

Review Date: 
January 25, 2015
Last Updated:
January 26, 2015