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Earlier lipid checks urged to prevent heart disease cases

High cholesterol levels in adolescence can cause structural and functional cardiac damage leading to premature heart damage and death, sparking researchers to call for earlier lipid checks.

According to the authors of a new UK study, cholesterol checks earlier in life could potentially prevent 20% of the adult population developing preventable heart problems.

“Public health experts, paediatricians, parents, and health policymakers should encourage early cholesterol checks, especially in the teenage years”

Andrew Agbaje

The NHS Health Check, which includes cholesterol tests, is currently offered every five years from the age of 40. But those behind the new research suggest tests should start much earlier.

They used data from the University of Bristol’s well known ‘Children of the 90s’ study, also known as the Avon Longitudinal Study of Parents and Children.

In total, data on 1,595 adolescents was analysed for the new study. Adolescents were 17 years old at baseline and were followed up for seven years until young adulthood at the age of 24.

The new research found high cholesterol and dyslipidaemia in children and adolescents upped the risk of premature death by their mid-40s and heart issues such as subclinical atherosclerosis in their mid-20s.

Cholesterol levels and evidence of heart damage were assessed at baseline and follow-up, noted the researchers.

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These included signs of heart structure damage, such left ventricular hypertrophy and high relative wall thickness, and signs of heart function damage, such as left ventricular diastolic dysfunction and increased left ventricular filling pressure.

Authors observed that increased low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and total cholesterol levels upped the risk of premature heart damage by 18% to 20%.

In addition, increased triglycerides doubled to tripled the risk of early structural and functional heart damage within seven years.

These results were seen both among adolescents with normal weight and among those considered overweight or obese, said the researchers.

They noted that some of these results were seen among those with normal blood pressure and those with elevated blood pressure as well.

The study authors also highlighted that the findings revealed that both males and females were affected alike.

They found that, while increased cholesterol contributed 30% to the direct damage of the heart, both increased fat mass and blood pressure indirectly contributed 40% to heart damage.

The remaining 30% could be explained by genetics and sedentary time, according to the researchers.

The new study was a collaboration between the University of Exeter, University of Bristol, and the University of Eastern Finland, with the results published in the journal Atherosclerosis.

Lead study author Dr Andrew Agbaje, from Exeter, said their findings showed that earlier cholesterol checks were needed.

He said: “We are seeing the first evidence of the catastrophic effects of elevated cholesterol levels on the heart more than two decades before the age of 40 – which is when current health guidelines recommend cholesterol check.

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“Waiting until the age of 40 years might result in one in five of the adult population developing preventable heart problems,” he said.

He added: “Public health experts, paediatricians, parents and health policymakers should encourage early cholesterol checks, especially in the teenage years.”

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