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    People Under 50 Aren't Safe From Heart Attacks


    Current guidelines recommend that patients and doctors strive for an LDL [the so-called "bad" cholesterol] level of less than 160 -- or 130 if the person has two other risk factors, such as diabetes, family history, or smoking. In people who already have heart disease, the LDL should be less than 100, to help prevent a heart attack or further blockage. If these guidelines cannot be met with diet and exercise, medication may be necessary.

    "The best way to prevent heart disease is to target all risk factors: smoking, obesity, a sedentary life, [high blood pressure]. ... It's not LDL alone," says Akosah. Interestingly, a significant number of the people admitted to the hospital in this study had not had their blood tested for cholesterol. The study's authors say this suggests a missed opportunity for heart-disease prevention.

    "[Akosah] certainly raises an important point that [heart] disease starts a lot earlier than we thought," Charles Cannon, MBChB, FACC, tells WebMD. Cannon, an interventional cardiologist at the University of Oregon Health Sciences University in Portland, reviewed the study for WebMD. Doctors should be aware of the risk factors and "treat them as aggressively as you can."

    Michael Criqui, MD, tells WebMD that it is important for doctors to look at their patients' HDL, or 'good,' cholesterol as well as the 'bad' LDL type. "HDL is critical," says Criqui, who served on an American Heart Association task force on risk reduction and is professor and vice chairman of the department of family and preventive medicine at the University of California, San Diego, School of Medicine.

    "Risk factors do count. " Criqui says. "The most totally preventable problem of all is cigarette smoking. In this study ... 60% of those with [heart] disease smoked. That's completely unacceptable.

    "If you do not want to develop [heart] disease before you're 50 years old, you need to be aware of your cholesterol and your HDL," Criqui says. "You need to not be obese ... to not smoke, to control your weight ... to avoid early diabetes and [high blood pressure]."

    "The only risk factors on this list you can't do anything about is being a male and family history. But you can modify your risk."

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