People need to tackle cholesterol early to lower the risks of a heart attack, according to US scientists who say the foundations for heart disease are laid down early in life.
Helen Hobbs at the University of Texas Southwestern Medical Center, Dallas, and her colleagues examined nearly 13,000 people enrolled in a comprehensive study of heart disease in Mississippi, Minnesota, North Carolina and Maryland, reported the online edition of Nature.
The results suggest that a modest reduction in low-density lipoprotein (LDL), a molecule that transports cholesterol in the blood over a lifetime, could slash one's risk of heart disease, the number-one killer in the US and many other Western countries.
LDL is strongly associated with heart disease. Doctors already know that reducing it with exercise or drugs can reduce a person's risk of heart attack. But it has been harder to find out whether heart health could be improved further by lowering LDL from a young age.
The study, published in the New England Journal of Medicine1, backs up growing evidence that the foundations for heart disease are laid down early in life.
The work is particularly significant because it focused on Americans who were at high risk of disease - many smoked, had hypertension or diabetes.
A healthy lifestyle could help - including exercise, weight control and diet with low saturated fat. When these measures are not enough, another possibility is prescribing cholesterol-lowering drugs such as statins to young adults. But this idea has not been well tested in clinical trials.
Developing drugs that mimic the effects of the LDL-lowering might also offer a way to combat rising cholesterol, the researchers propose.