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Just because you're young doesn't mean you shouldn't get a cholesterol screening

July 20, 2010

Health screenings — they might be tedious, expensive, and time-consuming, but they also can be worth it, even if you're a healthy young adult. Take the case of cholesterol screening. Even though today approximately two-thirds of young adults have one or more risk factors for coronary heart disease, less than 50% of them are screened for high cholesterol, according to a study published in the July-August issue of the Annals of Family Medicine.

Coronary heart disease, also known as coronary artery disease, is a buildup of calcium, plaque and fatty material in the arteries that restricts the flow of blood and oxygen to the heart and can lead to a heart attack. It's one of the leading causes of death and disability in the United States.

Screenings for heart disease and related conditions — such as diabetes, angina or hardening of the arteries in parts of the body other than the heart — increase as people age. Previous studies, such as a 2003 study from the Centers for Disease Control and Prevention, found that among adults aged 20 to 44, 60% had had their cholesterol levels checked in the preceding five years, compared with 89% of adults aged 45 and older.

The new study went further, finding that young adults are screened at low rates even when they already have heart disease risk factors.

Using data from 2,587 young adults — men aged 20 to 35 years; women aged 20 to 45 years — from the 1999-2006 National Health and Nutrition Examination Surveys, Dr. Elena Kuklina and colleagues tested to see whether the frequency of cholesterol screenings was higher for patients who had one or more risk factors for coronary heart disease, which include smoking, high blood pressure, obesity or family history of heart disease before age 50.

Rates of heart disease and related conditions as well as risk factors were high among the adults in the study — consisting of 59% of the sample. So were the rates of elevated "bad," or LDL, cholesterol. Elevated levels of LDL cholesterol were present in 7% of young adults with no risk factors, 12% with one risk factor, 26% with two or more risk factors and 65% of those with heart disease or related conditions.

"This is worrisome," said Kuklina, a fellow at the CDC's division of heart disease and stroke prevention. "Not only do a lot of young adults have [coronary heart disease] or its equivalents, but a large majority have high cholesterol too."

Elevated LDL cholesterol can easily be managed with medicine or lifestyle changes such as switching to a healthier diet, increasing physical activity and managing one's weight.

Kuklina suggests that the time and effort involved in instructing patients on how to make these changes may be deterring physicians from performing screenings.

For young adults who don't have the means or access to a cholesterol screening, Kuklina points out that many of the lifestyle changes don't require a doctor's help and can be made by people on their own.

"Remember that you can improve the number of risk factors by eating healthy, increasing your physical activity, stop smoking and monitoring your weight," she says. "You don't have to wait for the doctor to tell you what to do."

-- Jessie Schiewe, Los Angeles Times

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