Coronary Disease Prevention Critical In Young People

Coronary atherosclerosis begins at a young age. Indeed, atherosclerotic lesions are present in one of six United States teenagers. These are the alarming findings of a US study on the prevalence of coronary disease in asymptomatic teens and young adults.

The findings underline the critical need for intensive efforts at coronary disease prevention in young people, suggest these researchers. In this study, researchers at The Cleveland Clinic Foundation in Cleveland, Ohio used intravascular ultrasonography to investigate coronary arteries in young asymptomatic subjects.
This technique provides a unique opportunity for in vivo characterization of early atherosclerosis in a clinically relevant context, study authors note.

Until now, detailed in vivo data on atherosclerosis in young people have been limited, with most knowledge about the disease at young ages derived from necropsy studies, which have inherent limitations.
In this study, participants were 262 heart transplant recipients on whom intravascular ultrasound was performed an average of 30 days after transplantation.

The donor population consisted of 146 men and 116 women, averaging in their early 30s.

Researchers performed extensive imaging of all possible (including distal) coronary segments.

Sites with the greatest and least intimal thickness in each CASS segment were measured in multiple coronary arteries. Those sites with intimal thickness 0.5 mm were defined as atherosclerotic.

A total of 2,014 sites within 1,477 segments in 574 coronary arteries (2.2 arteries per person) were analysed.

In 136 patients, or 51.9 percent of subjects, an atherosclerotic lesion was present.

Prevalence of atherosclerosis varied from 17 percent in individuals less than 20 years old to 85 percent in those 50 years old.

In those people with atherosclerosis, intimal thickness averaged 1.08±0.48 mm and area stenosis averaged 32.7±15.9 percent.

For all age groups, the average intimal thickness was greater in men than women. However, prevalence of atherosclerosis was similar in men (52 percent) and women (51.7 percent).

Circulation. 2001;103:2705.