Elevated non-HDL earlier in life associated with CAC in mid-adulthood
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Elevated non-HDL was associated with coronary artery calcification in mid-adulthood, with the strongest association among those with high non-HDL in adolescence, researchers reported in JAMA Cardiology.
“The odds for the presence of coronary atherosclerosis attributable to non-HDL begins early in life, and greater awareness of the importance of elevated non-HDL in adolescence is needed,” Matthew K. Armstrong, PhD, postdoctoral research fellow at Menzies Institute for Medical Research at the University of Tasmania in Hobart, Australia, and colleagues wrote.
The Cardiovascular Risk in Young Finns Study, a population-based prospective cohort study, included 589 participants (56% women; aged 12-18 years at baseline) from three population centers in Finland. Data collection occurred from September 1980 to August 2008 with analysis beginning in February 2020.
Researchers determined CAC in 2008 from CT and characterized as no CAC with an Agatston score of 0 and as presence of CAC with an Agatston score of at least 1. Using these measures, researchers assessed the relative association between non-HDL at adolescence (mean age, 16 years), young adulthood (mean age, 24 years) and mid-adulthood (mean age, 39 years) and presence of CAC in mid-adulthood among the cohort.
Cumulative non-HDL exposure across every life stage was associated with CAC (OR = 1.5; 95% credible interval [CrI], 1.14-1.92) after adjusting for year of birth, sex, BMI, systolic BP, blood glucose level, smoking status, use of lipid-lowering and antihypertensive medications, and family history of heart disease.
There was a stronger association between CAC and exposure to non-HDL during adolescence (OR = 1.16; 95% CrI, 1.01-1.46) compared with young adulthood (OR = 1.14; 95% CrI, 1.01-1.43) and mid-adulthood (OR = 1.12; 95% CrI, 1.01-1.34).
According to the researchers, these estimates should be confirmed and extended to other CV outcomes of interest.
“Our results add to the growing evidence base underscoring the importance of early-life cardiovascular risk factors and provide new information regarding the relative association of non-HDL at different life stages with the presence of CAC,” the researchers wrote. “Altogether, early screening, identification and management of elevated non-HDL-C levels may represent an important goal toward reducing the burden of heart disease in adulthood.”
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