The presence of high blood pressure and other cardiovascular risk factors in young people has been linked to early development of fatty plaque in the arteries. Studying autopsies of 856 people between the ages of 15 and 34 who had died traumatically, researchers found that those who had risk factors such as high blood pressure, smoking or obesity already had fatty streaks and artery-clogging plaques in their abdominal aorta and coronary artery, even though their cholesterol levels were not raised.

Fatty streaks are the first stage in the development of coronary artery disease, or atherosclerosis; they are fat-filled cells in the inner lining of the artery. The second stage is development of a thickened plaque that gradually blocks an artery, cutting off blood supply to the heart or provoking a blood clot that rapidly blocks the artery and triggers a heart attack.

The risk between high lipid levels and heart disease is clear; however, this study clearly shows that the presence of non-lipid risk factors in young people is associated with more plaque that leads to coronary heart disease in middle age. This research, which was published in the American Heart Association’s journal Circulation, reinforces other findings that known coronary heart disease risk factors accelerate the development of atherosclerosis in children and adolescents, although symptoms don’t generally appear until middle age.

Nearly half the individuals in this study had at least one non-lipid risk factor, and 13 percent had two; smoking and hypertension were the most common. Those who smoked had more extensive fatty streaks and three times the extent of plaques. Obese males had more extensive fatty streaks and twice as many plaques as non-obese males. High blood pressure was associated with more extensive coronary artery plaques, particularly among blacks.

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