Young healthy people still died from cardiovascular disease if they had high levels of LDL cholesterol.

Young, healthy people may still face a lifetime risk of dying early from cardiovascular disease if they do not keep their cholesterol levels under control, according to new research.

Cholesterol is a type of fat found in your blood. You need a certain amount to produce hormones. But too much cholesterol sticks to your artery walls to form plaque. This plaque can build up and may block or narrow the artery. This process is called atherosclerosis.

If an artery becomes blocked this can result in a heart attack and if an artery to the brain is blocked, it may cause a stroke.

Studies to date have typically focused on people at moderate or high risk for cardiovascular disease however, a new US study looked at 36,375 young, relatively healthy participants who were free of diabetes or cardiovascular disease and followed them for 27 years.

The finding revealed that even young healthy people or those considered low risk still died from cardiovascular disease if they had high levels of LDL cholesterol.

Without taking into account other risk factors, people with LDL cholesterol levels in the range of 100-159 mg/dL had a 30 to 40 per cent higher risk of cardiovascular disease death and people with LDL levels of 160 mg/dL or higher had a 70 to 90 per cent increased risk of cardiovascular death, the study found.

“Our study demonstrates that having a low 10-year estimated cardiovascular disease risk does not eliminate the risk posed by elevated LDL over the course of a lifetime,” said lead study author Dr Shuaib Abdullah, University of Texas Southwestern Medical Center and Veteran’s Affairs North Texas Healthcare System in Dallas, Texas.

“Those with low risk should pursue lifestyle interventions, such as diet and exercise, to achieve LDLs levels as low as possible, preferably under 100 mg/dL. Limiting saturated fat intake, maintaining a healthy weight, discontinuing tobacco use, and increasing aerobic exercise should apply to everyone.”

Dr Robert Eckel, M.D., past president of the American Heart Association and Director of the Lipid Clinic at University of Colorado Hospital in Aurora said, “High cholesterol at younger ages means there will be a greater burden of cardiovascular disease as these individuals age. This research highlights the need to educate Americans of any age on the risks of elevated cholesterol, and ways to keep cholesterol at a healthy level throughout life.”

Commenting on the study Professor Ian Graham, Irish Heart Foundation Council on Cardiovascular Disease (CVD) Prevention and Professor of Cardiovascular Medicine at Trinity College Dublin, said that existing studies in this area started with individuals around the age of 40 and we are used to thinking about a person’s risk of developing cardiovascular disease within five or ten years’ time. However, he explained that more recently the focus has switched towards looking at a person’s lifetime risk.

A recent paper co-authored by Prof Graham looked at genetic factors that increased cholesterol by a small amount and found that while the effect of genetics on the 10-year risk was small, its effect on true lifetime risk was huge, because they operate from birth onwards.

“Seventy years of exposure to a small risk is like five years exposure to a very big risk,” he explained.

Prof Graham said, “We are not recommending expensive genetic testing but rather that cholesterol levels should be measured several times in childhood to identify kids whose levels are rising more quickly than they should, even if within the so-called normal range. Not to turn healthy kids into patients, but to identify those in whom an active approach to healthy diet and lifestyle is especially important. The same principles apply to blood pressure and probably to total risk score.”

Prof Graham added that this did not include people affect by familial hypercholesterolaemia which is where mutation in the gene has a very large effect on cholesterol, but rather polymorphisms or one or two changes in the gene that have much smaller effects.

This study was published recently in the American Heart Association’s journal Circulation.