2023-11-24 09:45:58
Subclinical atherosclerosis often progresses in middle-aged people, especially when LDL cholesterol levels and blood pressure are even mildly or moderately elevated.
A recent study investigated whether young people are more vulnerable than old people to the harmful effects of cholesterol and hypertension.
The study was carried out by a team co-led by Mr. Valentín Fuster, General Director of the National Center for Cardiovascular Research (CNIC) in Spain, director of the Cardiovascular Institute and “Physician-in-Chief” of the Mount Sinai Medical Center in New York in United States, and Dr. Borja Ibáñez, scientific director of the CNIC, cardiologist at the Jiménez Díaz Foundation University Hospital, and member of the Networked Biomedical Research Center for Cardiovascular Diseases (CIBERCV) in Spain.
Young people may be more susceptible to the harmful effects of certain factors that promote atherosclerosis. This is indicated by the results of the new study.
The authors of the study have concluded that young people are more vulnerable to the harmful effects of two of these factors: high cholesterol and blood pressure.
These results underscore the need for aggressive control of risk factors to begin at an earlier age in life, which is why, as the researchers maintain, “primary prevention strategies must change.”
Both the medical community and society should be aware that atherosclerosis is a disease that can stop its progression if risk factors are aggressively managed from an early age.
For this reason, Dr. Fuster emphasizes, “screening for subclinical atherosclerosis from an early age as well as aggressive control of risk factors could help alleviate the global burden of cardiovascular diseases.”
Example of local progression of atherosclerosis. (Image: CNIC / Mendieta G, Pocock S, Mass V, Moreno A, Owen R, García-Lunar I, López-Melgar B, Fuster JJ, Andres V, Pérez-Herreras C, Bueno H, Fernández-Ortiz A, Sanchez -Gonzalez J, García-Alvarez A, Ibáñez A, Fuster V. Determinants of Progression and Regression of Subclinical Atherosclerosis Over 6 Years. J Am Coll Cardiol. 2023 Nov, 82(22): 2069–2083. doi:/10.1016/j .jacc.2023.09.814)
Dr. Ibáñez explains that “in this work we have identified, among other findings, that the impact of moderately high cholesterol levels and blood pressure on the progression of atherosclerosis is much more marked in young people than in older people.”
There are few studies in the world that evaluate the presence of silent atherosclerosis, that is, in completely asymptomatic people, in apparently healthy young or middle-aged people, and how this disease progresses throughout life.
The PESA-CNIC-Santander (Progression of Early Subclinical Atherosclerosis) study began in 2009 and is the result of close collaboration between the CNIC and Banco de Santander. More than 4,000 middle-aged and apparently healthy volunteers from Banco Santander in Madrid participate in an exhaustive non-invasive imaging study every three years of various arterial territories (carotid, femoral, coronary and aorta). In addition, blood samples are collected to carry out advanced studies of genomic medicine, proteomics, metabolomics, etc. “The PESA study has already contributed very significantly to the knowledge of cardiovascular disease and is considered the most advanced in this field,” says Dr. Fuster.
In relation to prevention, this study shows us that the control of risk factors (mainly cholesterol and blood pressure) should begin at a very early age, a time when the arteries are most vulnerable to the damaging effect of these factors.
Dr. Borja Ibáñez explains that “these results open the door to a personalized medicine approach, where the intensity of risk factor control is guided by the presence and progression of silent atherosclerosis identified by imaging technology.”
Cardiologist Guiomar Mendieta, the first signatory of the work, adds that “another of the great findings of this work is that atherosclerosis, which until now had been considered an irreversible progressive phenomenon, can disappear if the risk factors are controlled early.” .
“These results have been possible thanks to the exhaustive collection of imaging and biochemical data over more than six years, as well as a very novel statistical approach,” says Dr. Mendieta.
The study is titled “Determinants of Progression and Regression of Subclinical Atherosclerosis Over 6 Years.” And it has been published in the academic journal Journal of the American College of Cardiology. (Source: CNIC)
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