Associations of Coronary Heart Disease Risk Factors With the Intermediate Lesion of Atherosclerosis in Youth

H. C. McGill, C. A. McMahan, A. W. Zieske, G. D. Sloop, J. V. Walcott, D. A. Troxclair, G. T. Malcom, R. E. Tracy, M. C. Oalmann, J. P. Strong, f. t. P. D. o. A. i. Youth Research Group
2000 Arteriosclerosis, Thrombosis and Vascular Biology  
The raised fatty streak (fatty plaque) is the gross term for the lesion intermediate between the juvenile (flat) fatty streak and the raised lesion of atherosclerosis. We measured the percentage of intimal surface involved with flat fatty streaks, raised fatty streaks, and raised lesions in the aortas and right coronary arteries of 2876 autopsied persons aged 15 through 34 years who died of external causes. Raised fatty streaks were present in the abdominal aortas of Ϸ20% of 15-to 19-year-old
more » ... bjects, and this percentage increased to Ϸ40% for 30-to 34-year-old subjects. Raised fatty streaks were present in the right coronary arteries of Ϸ10% of 15-to 19-year-old subjects, and this percentage increased to Ϸ30% for 30-to 34-year-old subjects. The percent intimal surface involved with raised fatty streaks increased with age in both arteries and was associated with high non-high density lipoprotein (HDL) and low HDL cholesterol concentrations in the abdominal aorta and right coronary artery, with hypertension in the abdominal aorta, with obesity in the right coronary artery of men, and with impaired glucose tolerance in the right coronary artery. Associations of risk factors with raised fatty streaks became evident in subjects in their late teens, whereas associations of risk factors with raised lesions became evident in subjects aged Ͼ25 years. These results are consistent with the putative transitional role of raised fatty streaks and show that coronary heart disease risk factors accelerate atherogenesis in the second decade of life. Thus, long-range prevention of atherosclerosis should begin in childhood or adolescence. (Arterioscler
doi:10.1161/01.atv.20.8.1998 pmid:10938023 fatcat:e2z7xny3e5h6vpslf245oaq2xy