The USPSTF also recommends that younger adults (men aged 20 to 35 and women aged 20 to 45) have their cholesterol tested to screen for lipid disorders if they have other risk factors for coronary heart disease. These other risk factors include diabetes, a family history of cardiovascular disease before age 50 years in male relatives or age 60 years in female relatives, a family history of familial hyperlipidemia and multiple cardiovascular risk factors including obesity, hypertension and tobacco use. The early treatment of these higher-risk individuals can prevent cardiovascular disease.
Currently, the USPSTF has no recommendation for or against routine cholesterol testing in younger adults (men aged 20 to 35 or women aged 20 to 45) in the absence of known risk factors for cardiovascular disease. The USPSTF found good evidence that cholesterol testing in low-risk young adults can detect some individuals at increased long-term risk of cardiovascular disease, but the absolute reduction in risk as a result of early treatment in most individuals is small before middle age.
Treatment options
Treatment options include both lifestyle changes and drug therapy. Lifestyle changes include dietary counseling to understand the benefits of a diet low in saturated fat and high in fruits and vegetables, regular exercise, stopping tobacco use and maintaining a healthy weight. Drug therapy can be more effective than any other treatment option alone and these include nicotinic acid derivatives, bile acid sequestrants, cholesterol absorption inhibitors, fibrates and statins. New research data suggests that statin therapy may lead to regression in atherosclerotic plaque, and more studies are being conducted to confirm this finding.
