Identifying barriers to risk assessment, early diagnosis, and prevention of premature cardiometabolic diseases.
Rates of cardiovascular events such as heart attacks, stroke, or abnormal heart beats in young adults has not decreased. Effective primary prevention is the best way to change this situation. Primary prevention is a complex of actions aimed to risk factors of disease to avoid the disease completely. Current screening algorithms for cardiovascular diseases are sufficiently effective in finding individuals in older populations who are at high risk of the disease and who are candidates for preventive therapy. The first step in all these decision-making algorithms is a calculation of cardiovascular risk. However, all current risk calculators are highly dependent on age and often under perform in young people. Consequently, many young adults remain unaware of their high risk of cardiovascular disease, do not receive further screening procedures, and do not receive preventive treatment. The main objectives of the proposed research are: 1) To evaluate, overall, by sex, and in comparison with people of the same age without heart disease, proportions of adults under 50 years old who have risk factors of heart disease, such as high blood cholesterol, diabetes, high blood pressure; 2) To discover how often high risk of heart disease in these patients is related to hereditary of complex traits; 3) To assess proportions of young patients with heart disease who were treated according to current guidelines after their first presentation with heart disease, and if desirable effects were achieved for those patients and if these proportions are different for men and women; 4) To assess how many of these patients had second cardiovascular events, such as heart attack, stroke blood vessel surgery, and/or heart failure after their first event, and if there rates are different for men and women. The public health impact of this study will be to generate important new health-related knowledge about the determinants of premature heart disease in a large population study. Understanding cardiovascular risk factors will enable the rational design of programs to specifically target these risk factors in terms of screening programs and preventative treatment strategies. Lastly, understanding the genetic causes of premature cardiovascular diseases will have immediate impact on improving the diagnosis and management of cardiovascular disease in young people. There is also optimism that molecular causes of premature heart disease could lead to the identification of new therapies.