High blood pressure, high cholesterol early in life tied to heart problems later

People with high blood pressure or elevated cholesterol before age 40 are more likely to have a heart attack later in life than other adults, a new analysis suggests.

The analysis pooled data from six studies involving a total of 36,030 people. Starting when participants were 53 years old on average, researchers tracked them to see who had heart attacks, strokes, or heart failure. 

By the time half of the people had been tracked for at least 17 years, participants who had high levels of “bad” LDL cholesterol before age 40 — that is, higher than about 129 milligrammes per decilitre of blood — were 64 per cent more likely to have had events like heart attacks compared to people with low LDL levels in early adulthood. 

The upper limit of normal blood pressure is 120/80. Younger adults who had high systolic blood pressure — the “top number” — were 37 per cent more likely to develop heart failure later in life. And young adults who had elevated diastolic blood pressure — the “bottom number” — were 21 per cent more likely to develop heart failure later on. 

“Many young adults feel OK, or they’re willing to think — I’m OK now, I will make healthful choices later when I’m older,” said Dr Andrew Moran, senior author of the study and a researcher at Columbia University Medical Centre in New York City. 

“This study shows that healthy choices matter even in young adults,” Moran said by e-mail. “This means not smoking, eating a healthful diet and exercising regularly.” 

And for some high risk young adults, starting medication to manage risk factors at a younger age — something that currently isn’t done as a matter of course — may be worthwhile, Moran added. 

Very few people in the study had high blood pressure or high cholesterol during young adulthood, researchers report in the Journal of the American College of Cardiology. 

During follow-up, 4,570 participants had events like heart attacks, 5,119 had heart failure events, and 2,862 had strokes. 

The study can’t explain whether or how high blood pressure or elevated cholesterol in early adulthood might directly cause heart attacks, strokes or heart failure later in life. 

One limitation of the analysis is that because the smaller studies used in the analysis didn’t have blood pressure and cholesterol measurements across the lifespan, in some cases researchers had to estimate how many younger adults had these risk factors based on the data they had for participants at older ages. 

“Heart failure and heart attacks are the result of years of exposure to risk factors like high blood pressure and cholesterol,” said Dr Samuel Gidding, coauthor of an editorial accompanying the study and medical director of the FH (Familial Hypercholesterolemia) Foundation in Pasadena, California. 

“Both cause the buildup of fat in the coronary arteries beginning in childhood; this leads to heart attack later in life,” Gidding said by e-mail. “High blood pressure puts extra strain on the heart and adapting to that stress leads to heart failure.”