Low‐Density Lipoprotein Cholesterol, Cardiovascular Risk Factors, and Predicted Risk in Young Adults

Abstract

ABSTRACTBackgroundYoung adults with elevated LDL‐C may experience increased burden of additional cardiovascular disease (CVD) risk factors. It is unclear how much LDL‐C levels, a modifiable factor, correlate with non‐LDL‐C CVD risk factors among young adults or how strongly these CVD risk factors are associated with long‐term predicted CVD risk. We quantified clustering of non‐LDL‐C CVD risk factors by LDL‐C among young adults to assess the association between non‐LDL‐C and LDL‐C risk factors with predicted CVD risk in young adults.MethodsThe current analysis is a cross‐sectional study of adults < 40 years with an LDL‐C< 190 mg/dL participating in the National Health and Nutrition Examination Survey (NHANES) between January 2015 and March 2020. We measured the prevalence of non‐LDL‐C risk factors by LDL‐C and association between LDL‐C and non‐LDL‐C risk factors with predicted risk of CVD by the Predicting Risk of cardiovascular disease EVENTs (PREVENT) equations.ResultsAmong 2108 young adults, the prevalence of LDL‐C ≥ 130 mg/dL was 15.5%. Compared with young adults with LDL‐C < 100 mg/dL, those with LDL‐C 100–< 130, 130–< 160, and 160–< 190 mg/dL had greater non‐LDL‐C risk factors. Both LDL‐C and non‐LDL‐C risk factors were independently associated with a 30‐year risk of CVD (OR 1.05, 95% CI 1.03–1.07 and OR 1.17, 95% CI 1.12–1.23, respectively). The association of LDL‐C and 30‐year risk did not vary by non‐LDL‐C risk factor burden (pinteraction = 0.43).ConclusionNon‐LDL‐C risk factors cluster among increasing levels of LDL‐C in young adults. Greater guidance on how to manage cardiovascular risk factors in young adults is needed.