Young people may be more susceptible to the harmful effects of factors that promote atherosclerosis. According to research from the National Center for Cardiovascular Research (CNIC), they are more susceptible to the harmful effects of two of these factors: high cholesterol and high blood pressure.
The results of this study will be published in the journal Journal of the American College of Cardiology, emphasize the need Aggressive control of risk factors should begin at a younger age Therefore, the researchers write, “primary prevention strategies need to change.”
The study was co-led by Valentin FusterDirector General of the CNIC, the Cardiovascular Institute and “Chief Physician” of the Mount Sinai Medical Center in New York (USA) and Borja Ibanezscientific director of the CNIC, cardiologist at the Fundación Jiménez Díaz University Hospital and member of the CIBERCV.
Subclinical atherosclerosis often progresses in middle-aged people, especially when LDL cholesterol levels and blood pressure are already mildly or moderately elevated. Both the medical community and society should be aware of this Atherosclerosis is a disease that can stop its progression when risk factors are treated aggressively from a young age.
For this reason, Fuster emphasizes, “early screening for subclinical atherosclerosis and aggressive control of risk factors could help alleviate the global burden of cardiovascular disease.”
Early screening for subclinical atherosclerosis and aggressive control of risk factors could help alleviate the global burden of cardiovascular disease.
Ibáñez explains: “In this work, we found, among other things, that the influence of moderately high cholesterol and blood pressure levels on the progression of atherosclerosis is much more pronounced in young people than in older people.”
Cases of progression of atherosclerosis (left) and regression (disappearance of it, right) in the carotid arteries (in the neck) and in the femoral arteries (groin). / CNIC
Research on asymptomatic people
There are few studies worldwide that evaluate the presence of silent arteriosclerosisthat is, in completely asymptomatic people, in apparently healthy young or middle-aged people, and how this disease progresses over the course of life.
The PESA-CNIC-Santander study (Progression of early subclinical atherosclerosis) started in 2009 and is the result of a close collaboration between CNIC and Banco de Santander.
More than 4,000 apparently healthy middle-aged volunteers from Banco Santander in Madrid participate every three years in a comprehensive non-invasive imaging study of different arterial territories (carotid, femoral, coronary arteries and aorta). In addition, blood samples are collected to conduct further studies in genomic medicine, proteomics, metabolomics, etc.
“The PESA study has already made a significant contribution to knowledge about cardiovascular diseases and is considered the most advanced in this field,” says Fuster.
The PESA study has already made a very important contribution to the knowledge of cardiovascular disease and is considered the most advanced in this field.
This work has very important implications for the field Cardiovascular prevention and in personalized medicine.
In terms of 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 effects of these factors.
Borja Ibáñez explains that “these results open the door to a personalized medicine approach in which the intensity of risk factor control is determined by the presence and progression of silent atherosclerosis identified by imaging technology.”
A reversible disease
The cardiologist Guiomar MendietaFirst signatory of the work, adds: “Another great finding of this work is that atherosclerosis, previously considered an irreversible progressive phenomenon, can disappear if risk factors are controlled early.”
“These results were possible thanks to the comprehensive collection of Imaging and biochemical data for more than 6 years, as well as a very innovative statistical approach,” says Mendieta, who joined the CNIC thanks to a joint training program between the CNIC and the Spanish Society of Cardiology.
These results were possible thanks to the extensive collection of imaging and biochemical data over more than six years
An editorial accompanying the study states: Charles A. German and Michael D. Shapirofrom the University of Chicago and Wake Forest University-Winston Salem, highlight the relevance of this research and write that its findings are a “call to action to rethink when and how physicians should intervene aggressively to treat cardiovascular disease. To prevent illnesses.”
The authors write that the research “expands our understanding of the natural progression of atherosclerosis and reinforces the idea that early detection and aggressive modification of risk factors, particularly lowering LDL cholesterol, can alter the course of the disease.” All of this, they add , lead to a “paradigm shift” with early, targeted and aggressive interventions to change course and prevent the impending tsunami of cardiovascular disease and other chronic diseases in our aging population.