Dyslipidemia is an established risk factor for cardiovascular disease (CVD) in older adults,1 though its impact in young adults and adolescents is less established. Findings from the Strong Heart Family Study (SHFS), a multicenter, prospective cohort study of CVD in American Indian populations, highlight the significance of dyslipidemia as a modifiable risk factor for CVD in younger populations, particularly in American Indian populations, which carry a high burden of cardiometabolic disorders.2

The SHFS provides nearly 20 years of data on dyslipidemia progression and CVD in 1,400 American Indian subjects from 15 to 39 years of age.2 Findings include a baseline prevalence of dyslipidemia in American Indian young adults of 55.2%, 73.6%, and 78.0% for individuals 15 to 19, 20 to 29, and 30 to 39 years of age, respectively, as compared to ~30% among U.S. adults 18 to 39 years of age.3 The use of lipid-lowering medication by study participants was 1.8% at baseline, and it remained low (8%) during the 5-year follow-up.

Thus, there is an opportunity for enhanced intervention, as elevated low-density lipoprotein cholesterol levels were independently associated with incident plaque, plaque progression, and CVD.


1Lee JS, Chang PY, Zhang Y, et al. Triglyceride and HDL-C dyslipidemia and risks of coronary heart disease and ischemic stroke by glycemic dysregulation status: the Strong Heart Study. Diabetes Care. 2017;40(4):529-537. doi:10.2337/dc16-1958.

2Reese JA, Roman MJ, Deen JF, et al. Dyslipidemia in American Indian Adolescents and Young Adults: Strong Heart Family Study. J Am Heart Assoc. 2024;13(6):e031741. doi:10.1161/JAHA.123.031741

3Bucholz EM, Gooding HC, de Ferranti SD. Awareness of cardiovascular risk factors in U.S. young adults aged 18–39 years. Am J Prev Med. 2018;54(4):e67–e77. doi:10.1016/j.amepre.2018.01.022.

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