Resolution of non-HDL-C dyslipidemia in children significantly cuts risk of CVD by adulthood: JAMA

A recent study published in the Journal of American Medical Association discovered that managing cholesterol levels from childhood could significantly reduce the risk of cardiovascular disease (CVD) in adulthood. The study spanned through several decades and followed participants from childhood through to their 40s to assess how variations in non-high-density lipoprotein cholesterol (non–HDL-C) levels affect the incidence of heart disease later in life.

Non-HDL-C is a critical measure of cholesterol that encompasses all harmful types of blood lipids and it has been identified as a reliable marker for predicting cardiovascular risks in adults. This extensive research was conducted across six prospective cohorts in the US and Finland to analyze data from individuals who were initially examined as children, starting from 1970 to 1996 with the follow-ups that continued until 2019.

The cohort of this study consisted of 5,121 participants with a balanced demographic representation including 60% women and 15% Black participants. This research tracked the non-HDL-C levels of participants from an average starting age of 10.7 years into their mid-adulthood by classifying the levels according to age- and sex-specific z-scores and existing clinical guidelines for dyslipidemia.

Over an average follow-up period of 8.9 years when the participants reached 40 years of age, 147 CVD events were observed. The analysis showed a strong association between both childhood and adult non-HDL-C levels and the elevated risk of CVD, with a more pronounced risk noted in the individuals with high non-HDL-C levels that persisted into adulthood. The hazard ratios (HR) were significantly high for individuals with sustained high non-HDL-C levels from childhood through to adulthood by indicating a fivefold increase in the risk of CVD events when compared to the individuals whose levels remained within the recommended range.

This study also found that individuals who managed to bring their non-HDL-C levels back to within the recommended range by adulthood did not face a significantly increased risk of heart disease which demonstrated similar risk levels to the individuals who never had dyslipidemia.

They suggest that interventions reduce elevated non-HDL-C levels in children could play a critical role to prevent the development of cardiovascular diseases later in life. Overall, the findings emphasize the importance of regular cholesterol monitoring from early childhood and continuing through adulthood along with lifestyle adjustments and medical interventions as required.

Source:

Wu, F., Jacobs, D. R., Jr, Daniels, S. R., Kähönen, M., Woo, J. G., Sinaiko, A. R., Viikari, J. S. A., Bazzano, L. A., Steinberger, J., Urbina, E. M., Venn, A. J., Raitakari, O. T., Dwyer, T., Juonala, M., & Magnussen, C. G. (2024). Non–High-Density Lipoprotein Cholesterol Levels From Childhood to Adulthood and Cardiovascular Disease Events. In JAMA. American Medical Association (AMA). https://doi.org/10.1001/jama.2024.4819