Eradicating Atherosclerosis: Should We Start Statins at Younger Ages and at Lower LDL-Cs

Curr Cardiol Rep. 2022 Oct;24(10):1397-1406. doi: 10.1007/s11886-022-01760-y. Epub 2022 Aug 25.

Abstract

Purpose of review: Given the increasing burden of cardiovascular disease, we review the literature for earlier initiation of statin therapy at younger ages and lower low-density lipoprotein cholesterol (LDL-C) levels, with the goal of preventing the development of atherosclerosis prior to clinical events.

Recent findings: There is a rising prevalence of dyslipidemia among younger adults. Although guidelines offer recommendations for adults over 40, there is little guidance for the management of younger adults with moderately elevated LDL-C levels. Earlier and more aggressive statin use may slow progression, or even halt atherosclerosis, and may likewise be beneficial and cost-effective on a population level. Further research is needed to define the exact age and LDL-C level at which to start statin therapy. Until then, more detailed risk stratification with lab testing and imaging should be used to identify younger adults at the highest risk.

Keywords: Atherosclerotic cardiovascular disease; Low density lipoprotein cholesterol; Primary prevention; Primordial prevention; Statin.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Atherosclerosis* / drug therapy
  • Atherosclerosis* / prevention & control
  • Cardiovascular Diseases* / prevention & control
  • Cholesterol, LDL
  • Dyslipidemias* / complications
  • Dyslipidemias* / drug therapy
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use

Substances

  • Cholesterol, LDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors