Many American Indian teens, young adults have dyslipidemia, elevated heart disease risk
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Key takeaways:
- The rates of dyslipidemia for American Indian adolescents and young adults are high.
- Those with high cholesterol at age 15 to 39 years had elevated risk for plaque in their arteries or heart disease.
In a cohort of American Indian individuals, more than 70% of young adults and more than 50% of adolescents had dyslipidemia, and some had subclinical or clinical heart disease, according to new data from the Strong Heart Study.
“We were surprised about the numbers, especially in adolescents,” Jessica A. Reese, PhD, an epidemiologist in the Center for American Indian Health Research at the University of Oklahoma Health Sciences Center, Oklahoma City, said in a press release. “These findings show the importance of early screenings and interventions, especially for teens and young adults who may be more likely to have underlying cardiovascular risks, diabetes or chronic liver disease.”
The analysis included 1,440 participants from the NIH-funded Strong Heart Study of families from 12 American Indian communities. All participants were aged 15 to 39 years at baseline in 2001-2003.
Participants were followed for a median of 5.5 years to detect carotid artery plaque and for a median of 18.5 years for incident CVD events.
At baseline, the prevalence of dyslipidemia was 55.2% in participants aged 15 to 19 years, 73.6% in those aged 20 to 29 years and 78% in those aged 30 to 39 years, Reese and colleagues found.
Among the cohort, 2.8% had LDL 160 mg/dL or greater, which meets the threshold for lifestyle modification or medical therapy in people aged 20 to 39 years, according to the researchers.
During the respective follow-up periods, 9.9% of participants had incident carotid artery plaque, 11% had plaque progression and 9% had incident CVD, Reese and colleagues wrote.
After adjustment for covariates, incident plaque and plaque progression were more likely in participants with total cholesterol at least 200 mg/dL (adjusted HR for incident plaque = 1.98; 95% CI, 1.31-2.99; aHR for plaque progression = 1.69; 95% CI, 1.16-2.47), LDL at least 160 mg/dL (aHR for incident plaque = 2.97; 95% CI, 1.43-6.18; aHR for plaque progression = 2.76; 95% CI, 1.43-5.33) or non-HDL at least 130 mg/dL (aHR for incident plaque = 1.67; 95% CI, 1.11-2.52; aHR for plaque progression = 1.47; 95% CI, 1.01-2.14), and incident CVD was linked to LDL at least 160 mg/dL (aHR = 2.44; 95% CI, 1.23-4.84), the researchers found.
Reference:
- More than half of American Indian youth may have abnormal or high cholesterol. https://www.eurekalert.org/news-releases/1036501. Published March 6, 2024. Accessed March 6, 2024.
Perspective
Back to TopThe Strong Heart Study is an important study of cardiovascular disease and its risk factors conducted among American Indians. Understanding heart disease risk factors in this population supports health care providers and their patients in tribal communities by identifying health disparities and promoting interventions to improve the health of American Indian people. As one major risk factor for coronary heart disease, dyslipidemia is common in the general U.S. population but has even more adverse impacts in indigenous communities. Identifying and addressing dyslipidemia among children and adolescents can facilitate discussions between health care providers and parents about how to reduce their children’s risk for heart disease, primarily through the establishment of healthy behaviors.
During formal listening sessions with tribal communities, The NHLBI has learned about the importance of promoting health and well-being for American Indian youth. Education, screening and treatment for heart disease risk factors such as dyslipidemia is one important approach to reducing health disparities from CVD. A proactive approach which addresses not only health behaviors (eg, a healthy diet and regular physical activity) and health care interventions but also social drivers of health is essential to improving health outcomes for American Indian people across the age spectrum. The goal is to promote and protect heart health and to mitigate the risk of heart disease in tribal communities.
The findings from this study show that there has to be a focus on early CVD risk detection, education and treatment, which is culturally appropriate. The purpose of these types of studies is to inform broader efforts to support culturally relevant treatments, research and education for tribal communities.
Elevated cholesterol is a risk factor for heart disease, and this study showed how elevated cholesterol levels in adolescents and young adults were associated with both atherosclerotic plaque development and future cardiovascular events.
Many adolescents and young adults have cardiovascular disease risks, such as obesity and abnormally elevated cholesterol. This is becoming a global phenomenon, and in Tribal communities, this research makes it more relatable and puts the focus on creating culturally focused ways of promoting health and taking steps to offset risks for disease.
Culturally adapted solutions — such as some measures already used by the Indian Health Service to support the health of tribal communities — are essential to strengthening and improving the CV health of American Indian populations, including teens and young adults.
Examples may range from supporting physical activity through native dance, running clubs, promoting heart-healthy eating through traditional foods and providing access to cholesterol screenings and education. These approaches are intended to be relevant and accessible to tribal communities.
We hope this study and others like it support culturally informed and adapted interventions (with a focus on tribal engagement and intervention). We want to help people identify health-protective factors for their community.
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