Prevalence and Extent of Atherosclerosis in Adolescents and Young Adults<SUBTITLE>Implications for Prevention From the Pathobiological Determinants of Atherosclerosis in Youth Study</SUBTITLE>

Abstract

Atherosclerosis begins in youth. Fatty streaks and clinically significant raised lesions increase rapidly in prevalence and extent during the 15- to 34-year age span. Primary prevention of atherosclerosis, as contrasted with primary prevention of clinically manifest atherosclerotic disease, must begin in childhood or adolescence.

Coronary calcification is more predictive of carotid intimal medial thickness in black compared to white middle aged men

“…In the other study [24], after stratifying data by sex in a similar age group, the lower CAC in black was significant in women but marginally significant in men. Pathologically, it has been reported that adolescent and young black men compared to their white counterparts have more extensive fatty streaks in their aorta and coronary arteries but similar raised lesions (fibrous plaques) [25] suggesting that black men have a slower progression rate of atherosclerotic lesions compared to white men. Doherty and colleagues [26] reported that black men suffer more CHD at a lower coronary calcium burden than white men.…”

Histological topographical comparisons of atherosclerosis progression in juveniles and young adults

“…8 Findings from the PDAY study, based on gross evaluations of atherosclerotic lesions, include: (1) fatty streaks (FS) begin at an earlier age in the thoracic aorta (TA) and the abdominal aorta (AA) compared to the right coronary artery (RCA); (2) a higher prevalence of FS in the TA compared to the AA and the RCA; (3) the prevalence of FS is lowest in the RCA than either segment of the aorta in the younger age groups; and (4) the prevalence of raised lesions (RL) is highest in the RCA than either segment of the aorta in the older age groups. 9 Although there is little difference in prevalence and extent of FS between the TA and the AA in either age group, there is a higher prevalence and extent of advanced lesions in the AA than in the TA in the older age group. These finding suggest that the vulnerability of FS to progress to advanced atheromatous lesions should differ according to these three arterial sites.…”

Carotid Atherosclerosis Detected by Ultrasonography: A National Cross‐Sectional Study

“…CA is also thought to be associated with cognitive impairment, which affects daily activities 6. The atherosclerotic process, however, may start at a young age and progresses silently over decades, so asymptomatic atherosclerosis is often neglected 7. Early detection and management of atherosclerosis may prevent cognitive impairment and reduce morbidity and mortality of CVDs 8…”