In men with risk factors for coronary artery disease, does initiating lipid screening earlier than 35 years of age reduce cardiovascular events?

摘要

Atherosclerosis is associated with considerable morbidity and mortality, and is a lifelong process proven to begin and progress throughout childhood and adolescence. One study suggests that approximately two-thirds of all young adults have 1 or more cardiovascular risk factors.2 Risk factors include hypertension, smoking, family history of CHD, and obesity. In addition, approximately 36% of adults aged 20 to 29 years and 43% aged 30 to 39 years meet dyslipidemia levels recommended by the National Cholesterol Education Program for all lipids. There is known benefit from lipid screening in men starting at age 35, and previous USPSTF recommendations from 2008 were to screen men aged 20 to 35 years with CHD risk factors.5 However, an updated systematic review of this recommendation concluded that there were no identified studies on benefits or harms of treatment versus no treatment regarding cardiovascular outcomes in adults aged 21 to 39 years.