More than 70% of American Indian young adults ages 20 to 39 and 50% of American Indian adolescents have high blood cholesterol or fat levels that put them at risk for cardiovascular disease, a study supported by the National Institutes of Health. In some cases, these levels (specifically high low-density lipoprotein (LDL) cholesterol, often considered “bad cholesterol”) have been linked to plaque buildup and cardiovascular events, such as heart attacks and strokes.
The findings, published in the Journal of the American Heart Association, comes from a 19-year review of the Strong Heart Family Study, part of the Strong Heart Study, the largest study of cardiovascular health outcomes and risk factors among American Indian adults. Researchers followed more than 1,400 participants, ages 15 to 39, between 2001-2003 and 2020. At the beginning of the study, 55% of participants ages 15 to 19 had abnormal cholesterol levels, as did 74% of those between 20 and 29 years old. and 78% of those between 30 and 39 years old.
“We were surprised by the numbers, especially in adolescents,” said Jessica A. Reese, Ph.D., an epidemiologist at the American Indian Health Research Center at the University of Oklahoma Health Sciences Center in Oklahoma. City. “These findings show the importance of early screening and interventions, especially for adolescents and young adults who may be more likely to have underlying cardiovascular risks, diabetes, or chronic liver disease.”
The researchers defined a person’s cholesterol as abnormal if they had high total cholesterol; high LDL cholesterol or other types of “bad” cholesterol; moderately high triglycerides; low HDL cholesterol, often considered “good cholesterol”; or if they had been prescribed cholesterol-lowering medications.
About 40% of study participants had high LDL levels (at least 100 mg/dL), while almost 3% had very high levels (at least 160 mg/dL). However, less than 2% of participants with very high LDL cholesterol took cholesterol-lowering medications at the start of the study.
“This research supports efforts to identify ways, such as increased screening and culturally relevant education, to improve heart health and support younger generations of Native Americans,” said Mona Puggal, MPH, epidemiologist in the Division of Science. National Heart Cardiovascular. Lung and Blood Institute (NHLBI), part of the NIH.
Heart disease is twice as common in American Indian adults compared to the general US population. The abnormal cholesterol levels seen among participants in the current study were also twice as high as the abnormal levels seen in the general population of U.S. adolescents and young adults. The researchers stressed the value of routine screening and screening. . All participants in this observational study were also notified of their laboratory tests and imaging results after their physical examination and were encouraged by the researchers to bring the results to their healthcare providers.
At the start of the study, 1,165 participants underwent ultrasounds of the carotid artery, an artery in the neck that carries blood from the heart to the brain. Approximately 61 (5%) showed signs of plaque or early plaque development. Plaque can impede blood flow to the heart or rupture when too much builds up in an artery, which can lead to a stroke or the need for surgery.
About 5.5 years after baseline measurements, 19 participants (about a third of those with detectable plaque) had signs of their plaque getting worse. Among the 1,104 who had no detectable plaque at first, 109 (10%) had signs of it during the second check-in. The researchers linked high levels of LDL cholesterol, total cholesterol, and other non-HDL cholesterol to these results.
At the end of the study, approximately 127 participants (9%) had suffered a heart attack, stroke, heart failure, or related cardiac surgery or death. Participants who had diabetes and at least some cardiovascular risks, such as large waists, high blood sugar, high triglycerides, high blood pressure, or low HDL cholesterol, were also more likely to experience cardiovascular events.
To support early risk detection, researchers emphasized the importance of youth staying connected to health care providers.
“It is important for everyone to work with their doctor to monitor cholesterol and blood sugar annually, which can support healthy living in the future,” said Ying Zhang, M.D., Ph.D., director of the Center for Cancer Research. American Indian Health. at the University of Oklahoma Health Sciences Center. “It is also vital that annual care be coordinated as youth mature, from consultation with pediatricians to adult healthcare providers.”
To learn more about cholesterol and heart health, visit: https://www.nhlbi.nih.gov/resources/cholesterol-your-heart-what-you-need-know-fact-sheet
This research was funded by NHLBI.