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Adolescent cholesterol checks may reduce premature heart damage and death

Paediatric cholesterol tests and the adoption of an ‘adolescent cholesterol passport’ could help prevent up to one-fifth of premature heart disease, a new study has revealed.

Published in the journal Atherosclerosis, the research shows that elevated levels of cholesterol and dyslipidaemia in children and adolescents increases the risk of heart issues such as subclinical atherosclerosis in their mid-20s and premature death by their mid-40s.

Scientists from the Universities of Exeter, Bristol and Eastern Finland found that earlier cholesterol checks, such as universal paediatric lipid screening, could reduce the number of adults suffering from preventable heart disease.

Using data from the University of Bristol’s ’Children of the 90’s’ cohort, also known as the Avon Longitudinal Study of Parents and Children, the researchers analysed data from 1,595 adolescents at the age of 17 and followed up with each participant for seven years. Cholesterol levels and evidence of heart damage were assessed at the start and throughout the follow-up period.

The scientists found an 18-20% increased risk of premature heart damage in adolescents with increased low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol and higher overall cholesterol levels.

An increase in triglycerides was also found to be associated with up to a three-fold increase in the risk of premature heart damage within seven years.

The study‘s lead author Dr Andrew Agbaje, paediatric clinical epidemiologist at the University of Eastern Finland and honorary research fellow at the University of Exeter, said: ‘Health guidelines generally recommend a cholesterol check by the age of 40 years. However, we are seeing the first evidence of the catastrophic effects of elevated cholesterol levels on the heart more than two decades earlier.

‘Waiting until age 40 years might result in one in five of the adult population developing preventable heart problems which are very expensive to treat.’

Elevated cholesterol levels were seen in both adolescents of a healthy weight and those considered overweight or obese.

The findings also revealed that while these increased levels were responsible for around a third of the direct damage to the heart, increased fat mass and blood pressure indirectly contributed to around 40% of heart damage.

The researchers showed that genetics and sedentary time could explain the remaining 30% of damage.

Dr Agbaje added: ‘Recently we discovered that increased sedentary time from childhood contributed 70% of the increase in cholesterol level before mid-20s and that engaging in light physical activity can completely reverse elevated cholesterol and dyslipidaemia.

‘Taken together, these findings suggest that being sedentary is at the root of health problems and childhood and adolescent sedentariness is a one-way ticket for cardiovascular diseases and death.’

The researchers state that public health experts, paediatricians, parents and health policymakers should encourage early cholesterol checks, especially in the teenage years, to reduce the risk of dyslipidaemia and to enable early preventive treatment.

And the adoption of an ‘adolescent cholesterol passport’ to help track any increases in cholesterol levels could help to initiate a timely preventive treatment in the young population.

A version of this article was originally published by our sister publication Nursing in Practice.

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