Prevalence and Extent of Atherosclerosis in Adolescents and Young Adults
May 1, 1999
Prevalence and Extent of Atherosclerosis in Adolescents and Young Adults
Source: Strong JP, et al. Prevalence and extent of atherosclerosis in adolescents and young adults. JAMA 1999; 281:727-735.
The pathobiological determinants of atherosclerosis in Youth (PDAY) Study reports atherosclerosis in 15- to 34-year-old men and women who underwent autopsy. Since fatty streaks and fibrous plaques commonly begin in this age group, the process of progressive lipid deposition, proliferation of smooth muscle, and ultimate mortal plaque rupture can be assessed in autopsy population studies.
The study included information from almost 3000 subjects, detailed primarily from pathologic evaluation of the thoracic aorta, abdominal aorta, and coronary arteries. As anticipated, the mean area involved and prevalence of atherosclerosis increased with age. The PDAY study showed that fatty streaks in the abdominal aorta and right coronary artery tend to be replaced with raised lesions like fibrous plaque and complicated atherosclerotic lesions.
Traditionally established risk factors were related to the progression from fatty streak to more complicated and more high-risk lesions. VLDL and LDL levels were directly associated with fatty streaks and raised lesions; HDL levels were indirectly associated with these lesions. Obesity, smoking, elevated glycohemoglobin levels, and hypertension were all associated with the negative pathologic arterial changes in these young men and women that we see reflected later as cardiovascular mortal and morbid end points. Strong and colleagues conclude that true primary prevention of atherosclerotic disease will have to begin prior to adolescence. (This Brief Report was written by Louis Kuritzky, Courtesy Clinical Assistant Professor, University of Florida, Gainesville.)
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content