Young people could also be more at risk of the consequences of elevated blood cholesterol and hypertension

Young people could also be more at risk of the consequences of the chance aspects for developing atherosclerosis. In keeping with a study carried out on the Centro Nacional de Investigaciones Cardiovasculares (CNIC), younger individuals are especially vulnerable to the damaging effects of elevated blood cholesterol and hypertension, two of the foremost modifiable cardiovascular risk aspects.

These findings, published within the Journal of the American College of Cardiology, underline the necessity to implement aggressive control of cardiovascular risk aspects at younger ages, requiring a change in primary prevention strategies to incorporate “surveillance of subclinical atherosclerosis and early cardiovascular risk factor control.”

The study was co-led by Dr. Valentín Fuster, CNIC General Director and Physician-in-Chief at Mount Sinai Medical Center in Latest York, and Dr. Borja Ibáñez, CNIC Scientific Director, a cardiologist at Hospital Universitario Fundación Jiménez Díaz, and a member of the CIBERCV cardiovascular research network in Spain.

Subclinical aterosclerosis often progresses in middle aged individuals, especially if LDL-cholesterol levels and blood pressure are even mildly or moderately elevated. Medical professionals and most people have to be aware that atherosclerosis progression could be stopped if risk aspects are managed agressively from an early age.

Screening for subclinical atherosclerosis from an early age along with aggressive risk-factor control could help to scale back the worldwide burden of heart problems.”

Dr. Valentín Fuster, CNIC General Director and Physician-in-Chief at Mount Sinai Medical Center in Latest York

Dr. Ibáñez explained that “on this study, we show that moderate increases in blood pressure and cholesterol have a way more pronounced impact on atherosclerosis progression in younger people.”

Only a few studies have investigated the progression of silent atherosclerosis in people who find themselves completely freed from symptoms, whether or not they are young or in apparently healthy middle-age, and the way this disease progresses throughout life.

The PESA-CNIC-Santander study (Progression of Early Subclinical Atherosclerosis) was launched in 2009 and is an in depth collaboration between the CNIC and Santander Bank. Greater than 4000 apparently healthy middle-aged Santander Bank employees in Madrid volunteered to undergo an exhaustive, noninvasive evaluation of the carotid, femoral, and coronary arteries and the aorta. Participants also provided blood samples for advanced genomic, proteomic, and metabolomic evaluation. “The PESA study has already made vital contributions to our understanding of heart problems and is taken into account essentially the most advanced study of its kind in the sphere,” said Dr. Fuster.

The present findings have vital implications for cardiovascular prevention and personalized medicine. The study shows that the control of risk aspects (principally elevated cholesterol and hypertension) should begin early in life, when the arteries are more vulnerable to the consequences of those risk aspects.

And as Dr. Borja Ibáñez emphasized, “these results point the approach to personalized approaches that use imaging technology to watch the presence and progression of silent atherosclerosis and guide the intensity of risk-factor control.”

Cardiologist Guiomar Mendieta, the primary writer on the study, added that “the opposite key finding of this study is that atherosclerosis, previously believed to be irreversible, can disappear if risk aspects are controlled from an early stage.”

“These findings are the consequence of the exhaustive collection of imaging and biochemical data over 6 years, combined with an progressive statistical evaluation,” explained Dr. Mendieta, who joined the CNIC through the CARDIOJOVEN SEC-CNIC training program, a joint initiative of the CNIC and the Spanish Society of Cardiology.

The CNIC investigators received funding from the European Commission (ERC-CoG 819775 and H2020-HEALTH 945118), the Spanish Ministry of Science and Innovation (PID2019‐110369RB‐I00), and the Community of Madrid regional government (P2022/BMD-7403, RENIM-CM).