Early Adult Levels of Heart Disease Risk Factors Predict Development of Coronary Artery Calcium in Middle Age

Young adult levels of modifiable risk factors predict the odds of developing heart disease in middle age as well as or better than levels of risk factors measured in middle age, according to a large, multicenter study funded by the National Heart, Lung, and Blood Institute (NHLBI) and published in 2007 in the Journal of American College of Cardiology.

The findings suggest that that waiting until modifiable risk factor levels reach clinical guideline thresholds to prevent heart disease may not be desirable because plaque calcification is already underway and may be accelerating by middle age.

The study was based on data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, which recruited 5,115 African American and white men and women between the ages of 18 and 30, balanced by age, sex, race, and educational status. Participants were examined initially in 1985-86 in four U.S. cities (Birmingham, Ala.; Chicago, Ill.; Minneapolis, Minn.; and Oakland, Calif.). Follow-up examinations were performed 2, 5, 7, 10, and 15 years later.

Prior to this analysis of CARDIA data, little research had used multiple measures over the course of time to predict the development of atherosclerosis, a leading cause of heart disease. In addition, a common clinical approach to addressing heart disease risks has been to wait until risk factors develop to prescribe lifestyle changes or treatment.

The study suggests that earlier risk assessment and efforts to encourage young adults to achieve and maintain optimal levels may be needed to prevent or delay the development of coronary artery calcium, which has been shown to predict heart disease.

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