If you’re in your 30s and have high cholesterol, you might want to take steps to get it into a healthier range, new research suggests. The longer people have elevated cholesterol levels, the higher their risk of having a heart attack, stroke, or other signs of heart disease by the time they hit their 70s.
Researchers from Duke and Boston universities looked at cholesterol levels in nearly 1,500 adults from the Framingham Heart Study who were free of heart disease at age 55 and followed them for 20 years. They found that about 17 percent of those who had elevated cholesterol levels since their 30s — defined as a reading of 130 mg/dL or above for “bad” LDL cholesterol — wound up with heart disease. That compares to 8 percent of those who had elevated cholesterol throughout their 40s and 4 percent of those who didn’t have elevated cholesterol before age 55.
“Every 10 years that a person has elevated cholesterol was associated with an almost 40 percent increased risk of heart disease,” said study author Dr. Ann Marie Navar-Boggan, cardiology fellow at Duke University Medical Center.
This trend was seen even in otherwise healthy study participants who exercised, weren’t overweight, and didn’t have diabetes.
Does this mean younger folks with high cholesterol should be taking cholesterol-lowering statin drugs to slash their heart disease risk?
The latest recommendations issued last year by the American College of Cardiology and American Heart Association recommend that doctors prescribe statins to people with a low 10-year heart attack risk — which includes most adults under age 60 — only if they have a very high LDL reading of 190 mg/dL or above.
Navar-Boggan said lifestyle modifications to lower cholesterol, such as reducing saturated fat intake, increasing physical activity, and eating less to lose weight, should be the first course of action. If those don’t work, she would consider prescribing statins to a 45-year-old woman with moderately high cholesterol and no other heart disease risk factors.
Some cardiology experts disagree with this approach because statins offer minimal benefits to those at low heart disease risk — often at the cost of side effects like muscle aches which make it harder to exercise. “While some young individuals with a strong family history will have cholesterol levels high enough to justify treatment, the real message here is the importance of diet, exercise, and smoking cessation early in life,” said Dr. Paul Ridker, director of the center for cardiovascular disease prevention at Brigham and Women’s Hospital.