Nonlipid risk factors, including smoking, hypertension, and obesity, were associated with more extensive coronary and aortic atherosclerosis in youth despite favorable lipoprotein profiles.
Observational (n=856)
Yes
Do nonlipid risk factors increase the extent and severity of atherosclerosis in youth with a favorable lipoprotein profile?
Nonlipid risk factors significantly contribute to the development of atherosclerosis in youth even when lipid profiles are favorable, highlighting the need for comprehensive risk factor control.
BACKGROUND: The strong association between coronary heart disease and dyslipoproteinemia has often overshadowed the effects of the nonlipid risk factors-smoking, hypertension, obesity, and diabetes and impaired glucose tolerance-and even led to questioning the importance of these risk factors in the presence of a favorable lipoprotein profile. METHODS AND RESULTS: A cooperative multicenter study, the Pathobiological Determinants of Atherosclerosis in Youth (PDAY), examined the relation of the nonlipid risk factors to atherosclerosis in 629 men and 227 women 15 to 34 years of age who died of external causes and who had a favorable lipoprotein profile (non-HDL cholesterol /=0.91 mmol/L >/=35 mg/dL). In the abdominal aorta, smokers had more extensive fatty streaks and raised lesions than nonsmokers, and hypertensive blacks had more raised lesions than normotensive blacks. In the right coronary artery, hypertensive blacks had more raised lesions than normotensive blacks, obese men (body mass index >/=30 kg/m(2)) had more extensive fatty streaks and raised lesions than nonobese men, and individuals with impaired glucose intolerance had more extensive fatty streaks. Obese men had more severe lesions (American Heart Association grade 2 through 5) of the left anterior descending coronary artery. CONCLUSIONS: These substantial effects of the nonlipid risk factors on the extent and severity of coronary and aortic atherosclerosis, even in the presence of a favorable lipoprotein profile, support the need to control all cardiovascular risk factors.
McGill et al. (2001) conducted an observational in Atherosclerosis (n=856). Nonlipid risk factors (smoking, hypertension, obesity, impaired glucose tolerance) vs. Absence of respective risk factors was evaluated on Extent and severity of coronary and aortic atherosclerosis (fatty streaks and raised lesions). Nonlipid risk factors, including smoking, hypertension, and obesity, were associated with more extensive coronary and aortic atherosclerosis in youth despite favorable lipoprotein profiles.