Risk scores identify young people with hardened arteries

Armed with more knowledge about what cardiovascular disease looks like in people ages 15 to 34, co-authors from the University of Texas Health Science Center, the Southwest Foundation for Biomedical Research and institutions in Delaware, New York, Pennsylvania and Louisiana will report Monday that the same measurements done in a routine physical – of blood cholesterol, blood sugar, blood pressure, and weight and height – can effectively be used to identify young people who show early evidence of hardening of the arteries, also called atherosclerosis.

The study, to be published in the Archives of Internal Medicine, examined arteries and samples of blood and other tissues from more than 1,100 young people who died of external causes such as motor vehicle accidents and were autopsied in forensic laboratories. Risk factors such as high cholesterol, identified from the blood samples, were correlated with evidence of atherosclerotic lesions in the coronary arteries and the abdominal aorta.

The researchers developed risk scores to calculate the probability of advanced lesions relative to age, sex, cholesterol, smoking, high blood pressure, obesity and elevated blood sugar.

“This new study provides a summary of how the risk factors act together in young people,” said lead author C. Alex McMahan, Ph.D., the statistician for the study and professor of pathology at the Health Science Center. The other senior co-author from San Antonio is Henry C. McGill Jr., M.D., professor and chairman emeritus of pathology at the Health Science Center and senior scientist emeritus at the Southwest Foundation for Biomedical Research.

Scientists first observed in the 1950s that hardening of the arteries begins in young people. “What we have now shown is the relationship between these early lesions in young people and the traditional heart disease risk factors known to be associated with heart disease in older people – smoking, high cholesterol, high blood pressure, obesity and diabetes,” Dr. McMahan said.

He said the risk assessment needs to be expanded as new technologies are developed to image the early blood vessel lesions.

The study was supported by several grants from the National Heart, Lung, and Blood Institute to institutions in Alabama, New York, Texas, Illinois, Louisiana, Maryland, Georgia, Nebraska, Ohio, Tennessee and West Virginia.