Elevated Blood Pressure, Cholesterol in Young Adulthood Increases CVD Risk

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Investigators assessed the independent relationships between young adult exposure to risk factors and risk for cardiovascular disease later in life, taking into consideration later adult exposures.

Young adults who experience elevated systolic blood pressure (SBP), diastolic blood pressure (DBP), and low-density lipoprotein cholesterol (LDL-C) have increased risks for cardiovascular disease (CVD) later in life, independent of adult levels, according to results published in the Journal of the American College of Cardiology.

The study included data from 6 cohorts, with observations that spanned from young adulthood to later life in the United States (N=36,030). The data also included risk factor trajectories for LDL-C, high-density lipoprotein cholesterol (HDL-C), SBP, and DBP for each participant, starting at age 18 years. Researchers calculated time-weighted average exposures to each risk factor during young (aged 18-39 years) and later (age ≥40 years) adulthood and linked them to subsequent risks for coronary heart disease, heart failure (HF), or stroke.

During a median follow-up of 17 years, there were 4570 incidences of coronary heart disease, 5119 of HF, and 2862 of stroke.

After using a model that considered both young and later adult risk factors, the researchers found that young adult LDL-C ≥100 mg/dL was associated with a 64% increased risk for coronary heart disease compared with LDL-C <100 mg/dL, independent of later adult risk factors.

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The results also indicated that young adult SBP ≥130 mm Hg was independently associated with a 37% increased risk for HF compared with SBP <130 mm Hg. Young adult DBP ≥80 mm Hg was independently associated with a 21% increased risk for HF compared with DBP <80 mm Hg.

“These findings suggest that investment now in programs to control modifiable risk factors during young adulthood has the potential to reduce the future burden of CVD,” the researchers wrote.


Zhang Y, Vittinghoff E, Pletcher MJ, et al. Associations of blood pressure and cholesterol levels during young adulthood with later cardiovascular events. J Am Coll Cardiol. 2019;74(3):330-341.