They used a computer simulation model to assess the lifetime health effects and cost-effectiveness of initiating cholesterol-lowering treatment in a cohort of U.S. population and compared lifestyle and pharmacologic approaches to cholesterol-lowering in young adults aged 18 to 39 years. The study by Moran and colleagues examined the prevalence of elevated LDL cholesterol in the U.S. Only about 2% of young adults in the United States have LDL levels that high, usually indicative of a genetic disorder that confers lifelong cardiovascular risk. A recent study of observational data found that, when adjusting for relevant covariates, cumulative exposure to LDL cholesterol in young adulthood substantially increases risk of later life cardiovascular events.Ĭlinical guidelines from the American College of Cardiology/American Heart Association currently recommend that statins only be used for cholesterol-lowering in young adults with extremely high levels of LDL cholesterol (≥190 mg/dL). LDL cholesterol plays an important role in the development of atherosclerosis, the buildup of fibro-fatty plaque in the arteries and the primary cause of cardiovascular disease (heart attacks and strokes).
The study, led by Columbia’s Andrew Moran, MD, MPH, associate professor of medicine, and Ciaran Kohli-Lynch, PhD, research scientist, was published in the Journal of the American College of Cardiology. An editorial comment accompanying the new paper suggests that guidelines should consider how many years of life a patient may lose from unhealthy LDL levels and that treatment should be considered for adults with high LDL regardless of age.
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