Cholesterol Evaluation in Young Adults: Absence of Clinical Trial Evidence Is Not a Reason to Delay Screening
Authors: Paul M Ridker, Nancy R. Cook
Journal: Annals of Internal Medicine (2017)

Editorials20 June 2017Cholesterol Evaluation in Young Adults: Absence of Clinical Trial Evidence Is Not a Reason to Delay ScreeningPaul M Ridker, MD, MPH and Nancy R. Cook, ScDPaul M Ridker, MD, MPHFrom Brigham and Women's Hospital, Boston, Massachusetts. and Nancy R. Cook, ScDFrom Brigham and Women's Hospital, Boston, Massachusetts.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-0855 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Hypercholesterolemia is an asymptomatic disorder that is present years, if not decades, before the onset of myocardial infarction, stroke, or sudden cardiovascular death. The detection of hypercholesterolemia in young adulthood is one of several important steps, along with smoking cessation, blood pressure control, dietary education, and exercise promotion, that may be taken for the primary prevention of cardiovascular disease. This is particularly true for persons affected by familial hypercholesterolemia (FH), a set of genetic disorders with a prevalence of 1 in 250 in the United States (1). Familial hypercholesterolemia is associated with markedly premature vascular events, for which aggressive lifestyle ...References1. de Ferranti SD, Rodday AM, Mendelson MM, Wong JB, Leslie LK, Sheldrick RC. Prevalence of familial hypercholesterolemia in the 1999 to 2012 United States National Health and Nutrition Examination Surveys (NHANES). Circulation. 2016;133:1067-72. [PMID: 26976914] doi:10.1161/CIRCULATIONAHA.115.018791 CrossrefMedlineGoogle Scholar2. Gidding SS, Champagne MA, de Ferranti SD, Defesche J, Ito MK, Knowles JW, et al; American Heart Association Atherosclerosis, Hypertension, and Obesity in Young Committee of Council on Cardiovascular Disease in Young. Council on Cardiovascular and Stroke Nursing. Council on Functional Genomics and Translational Biology. Council on Lifestyle and Cardiometabolic Health. The agenda for familial hypercholesterolemia: a scientific statement from the American Heart Association. Circulation. 2015;132:2167-92. [PMID: 26510694] doi:10.1161/CIR.0000000000000297 CrossrefMedlineGoogle Scholar3. Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D'Agostino RB, Gibbons R, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129:S49-73. [PMID: 24222018] doi:10.1161/01.cir.0000437741.48606.98 CrossrefMedlineGoogle Scholar4. U.S. Preventive Services Task Force. Lipid disorders in adults (cholesterol, dyslipidemia): screening. Accessed at www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lipid-disorders-in-adults-cholesterol-dyslipidemia-screening on 4 April 2017. Google Scholar5. Chou R, Dana T, Blazina I, Daeges M, Bougatsos C, Jeanne TL. Screening for dyslipidemia in younger adults: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2016;165:560-564. [PMID: 27538032]. doi:10.7326/M16-0946 LinkGoogle Scholar6. Patel KK, Taksler GB, Hu B, Rothberg MB. Prevalence of elevated cardiovascular risks in young adults: a cross-sectional analysis of National Health and Nutrition Examination Surveys. Ann Intern Med. 2017;166:876-82. doi:10.7326/M16-2052 LinkGoogle Scholar7. Khera AV, Won HH, Peloso GM, Lawson KS, Bartz TM, Deng X, et al. Diagnostic yield and clinical utility of sequencing familial hypercholesterolemia genes in patients with severe hypercholesterolemia. J Am Coll Cardiol. 2016;67:2578-89. [PMID: 27050191] doi:10.1016/j.jacc.2016.03.520 CrossrefMedlineGoogle Scholar8. Strong JP, Malcom GT, McMahan CA, Tracy RE, Newman WP, Herderick EE, et al. Prevalence and extent of atherosclerosis in adolescents and young adults: implications for prevention from the Pathobiological Determinants of Atherosclerosis in Youth Study. JAMA. 1999;281:727-35. [PMID: 10052443] CrossrefMedlineGoogle Scholar9. Wald DS, Bestwick JP, Wald NJ. Child–parent familial hypercholesterolemia screening in primary care [Letter]. N Engl J Med. 2017;376:499-500. [PMID: 28146661] doi:10.1056/NEJMc1615365 CrossrefMedlineGoogle Scholar10. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011;128 Suppl 5:S213-56. [PMID: 22084329] doi:10.1542/peds.2009-2107C CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Brigham and Women's Hospital, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-0855.Corresponding Author: Paul M Ridker, MD, MPH, Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, 900 Commonwealth Avenue, Boston, MA 02215; e-mail, [email protected]org.Current Author Addresses: Drs. Ridker and Cook: Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, 900 Commonwealth Avenue, Boston, MA 02215.This article was published at Annals.org on 16 May 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrevalence of Elevated Cardiovascular Risks in Young Adults: A Cross-sectional Analysis of National Health and Nutrition Examination Surveys Krishna K. Patel , Glen B. Taksler , Bo Hu , and Michael B. Rothberg Metrics Cited byAssociation and Risk Factors for Hypertension and Dyslipidemia in Young Adults from PolandHypercholesterolemia at a young ageAssociations of Blood Pressure and Cholesterol Levels During Young Adulthood With Later Cardiovascular EventsLegacy effects of statins on cardiovascular and all-cause mortality: a meta-analysisCardiovascular event reduction with PCSK9 inhibition among 1578 patients with familial hypercholesterolemia: Results from the SPIRE randomized trials of bococizumab 20 June 2017Volume 166, Issue 12Page: 901-902KeywordsAdolescentsCardiovascular diseasesCholesterolFamilial hypercholesterolemiaHypercholesterolemiaLipidsLow density lipoprotein cholesterolMyocardial infarctionStatinsYoung adults ePublished: 16 May 2017 Issue Published: 20 June 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...