It is estimated that millions of Americans are walking around with dangerous levels of “bad” cholesterol in their blood well before they turn 40. But many have no idea, because doctors don’t typically examine, much less treat, people for high cholesterol in their 20s or 30s. U.S. guidelines do not require Americans to be screened during young adulthood, but some doctors think that should change considering that high cholesterol rates are rising and the disease is a leading cause of heart attacks and accidents. cerebral vascular.
See why screening starts later in life and why some cardiologists are skipping the records.
First, what is considered high cholesterol?
When your doctor says your cholesterol is “high,” it typically refers to combined blood levels of “good” high-density lipoprotein (HDL) cholesterol and “bad” low-density lipoprotein (LDL) cholesterol above 200 milligrams. per deciliter (mg/dL). But it is the high levels of LDL – 160 mg/dL or higher – cholesterol that make this number worrying. It’s important that your combined cholesterol number stays relatively low and that your HDL levels are higher than your LDL levels, because “good” cholesterol helps remove artery-hardening “bad” cholesterol, according to Medline.
Levels are considered healthy if:
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Total cholesterol is below 200
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LDL cholesterol is below 100
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HDL cholesterol is 60 or higher
You are considered at risk or high limit if:
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Total cholesterol is between 200 and 239
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LDL cholesterol is between 100 and 159
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HDL cholesterol is between 40 and 59 for men, or 50 and 59 for women
And the levels are high if:
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Total cholesterol is 240 or higher
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LDL cholesterol is 160 or higher
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HDL cholesterol is less than 40 for men or less than 50 for women
Scientists haven’t studied cholesterol much in young people
In general, doctors test for signs of health problems and then decide the best treatment.
But doctors work backwards when it comes to high cholesterol in young adults, Dr.professor of general medicine at Columbia University whose research focuses on preventing cardiovascular disease, told Yahoo Life.
Treating high cholesterol with medication is not recommended by the US Preventive Services Task Force (USPSTF) for anyone under age 40. In fact, USPSTF recommendations say that cholesterol-lowering medications should only be given to patients ages 40 to 75 if they have at least a 7.5% risk of heart disease in the next 10 years. . The widely used heart disease risk calculator nor does it calculate heart disease risks for someone under 40. And the USPSTF no longer has a separate guideline for screening without treatment. “So, many [health care providers] Think, ‘Why should I get tested for high cholesterol if there’s nothing I can do about it?’” in terms of prescribing, says Moran.
The most commonly prescribed medications to treat cholesterol are statins. Doctors prescribe them because statins have been extensively studied and shown to be safe and effective in large, gold-standard clinical trials — but there haven’t been many such trials involving young adults.
In part, this is because it would be expensive and slow to test whether statins work in young people. The important measure for a clinical trial of statins is whether people who take them have fewer heart attacks and strokes than those who don’t take the drugs. “To conduct a clinical trial, if you have a limited budget, the smartest thing to do is find the people who are at relatively high risk, because in a relatively short period of time, you will be able to measure the difference,” explains Moran. . “With young people, this” – a major cardiovascular event – “probably won’t happen for another 20 or 30 years.”
So if scientists don’t proven Although statins work and are safe for young people, U.S. health agencies do not recommend the drugs and doctors do not prescribe them. And if there is nothing to prescribe to lower a young person’s cholesterol, then the guidelines suggest there is little reason to get tested.
But some cardiologists think this is incorrect.
Lowering cholesterol early may delay or prevent heart disease
Driven in part by American diets, many young adults already have high or near-high cholesterol in their 20s and 30s. The Centers for Disease Control and Prevention estimates that 7.5% of Americans between the ages of 20 and 39 have high total cholesterol (greater than 240 mg/dL). Moran’s to look for suggests that up to 27% of young adults have high levels of “bad” LDL cholesterol (the type responsible for plaques and heart attacks) but do not yet have heart disease. And about 40% of Americans of any age don’t know their cholesterol level, according to a recent study published in JAMA Cardiology.
Cholesterol accumulates in the bloodstream throughout life, starting in childhood. Therefore, the sooner you act, the better. High cholesterol can certainly be controlled and treated later in life, but it “wouldn’t have the same [same] impact if they had started at age 30. It’s easier to get [cholesterol] decrease the younger you are”, Dr Muhammad Siyab Panhwarinterventional cardiologist at Sanford Health, told Yahoo Life.
If someone’s cholesterol is checked when they are in their 20s or 30s, there is a good chance that lifestyle changes—such as a healthier diet, more exercise, less alcohol, and quitting smoking—will be enough to maintain your levels under control. Limiting the saturated fats found only in red meat and dairy products can reduce bad cholesterol levels by up to 10%, according to the Mayo clinic.
These changes are always the first choice in managing cholesterol in young adults, says Panhwar. But “if you did everything of [non-medication] things and are still struggling with high cholesterol, you need to consider medication,” he says. “There is no other option. There is no supplement that some Internet health and wellness guru sells you that can reduce it.
There are some valid concerns about the side effects of statins, says Moran. Taking them long-term may increase your risk of developing type 2 diabetes. But for millions of Americans with high cholesterol, “research on this topic shows that the benefit of preventing heart attacks and strokes outweighs the risk of diabetes.” , says Moran.
But the first and most important step is screening. Although it’s not recommended by guidelines, Moran and Panhwar advise young adults to ask their doctors to check their cholesterol, especially if they have a family history of high cholesterol or heart problems. “If I have a 30-year-old person with high cholesterol in my clinic, I’m not going to wait 10 years until they turn 40 and then use a calculator to calculate a little score for them,” says Panhwar. “This is nonsense. They need treatment now, not after 10 years of uncontrolled high cholesterol.”
