(HealthDay News) — Many individuals without cardiovascular risk factors (CVRFs) have atherosclerosis, with low-density lipoprotein cholesterol (LDL-C) independently associated with the presence and extent of atherosclerosis, according to a study published in the Journal of the American College of Cardiology.
Leticia Fernández-Friera, MD, PhD, from the Centro Nacional de Investigaciones Cardiovasculares Carlos III in Madrid, and colleagues examined predictors of subclinical atherosclerosis in CVRF-free individuals. A total of 1,779 participants from the Progression of Early Subclinical Atherosclerosis study without conventional CVRFs (45.0 ± 4.1 years; 50.3% women) were assessed. A subgroup of 740 patients had optimal CVRFs.
The researchers found that 49.7% of CVRF-free participants had subclinical atherosclerosis (plaque or coronary artery calcification). In addition to male sex and age, LDL-C was independently associated with the presence and extent of atherosclerosis in the CVRF-free and CVRF-optimal groups (odds ratio, 1.14 to 1.18). The presence and extent of atherosclerosis was also associated with glycosylated hemoglobin levels in the CVRF-free group.
“Many CVRF-free middle-aged individuals have atherosclerosis. LDL-C, even at levels currently considered normal, is independently associated with the presence and extent of early systemic atherosclerosis in the absence of major CVRFs,” the authors write. “These findings support more effective LDL-C lowering for primordial prevention, even in individuals conventionally considered at optimal risk.”
Fernández-Friera L, Fuster V, López-Melgar B, et al. Normal LDL-Cholesterol levels are associated with subclinical atherosclerosis in the absence of risk factors. JACC, 2017 Dec. doi: 10.1016/j.jacc.2017.10.024