High cholesterol, especially LDL or “bad” cholesterol, is one of the main risk factors for the development of cardiovascular diseases, including myocardial infarction and stroke. Although its effect may take years to manifest, fatty plaques in the arteries begin to build up long before symptoms appear. This is why experts insist that prevention should start at an earlier age than many people think. Some recent studies and clinical guidelines such as those from the American Heart Association (AHA), the American College of Cardiology (ACC), and the US Preventive Services Task Force (USPSTF) agree that there are specific age groups in which it is most effective to act on cholesterol to significantly reduce the risk of heart attacks in the long term.
From 20 to 39 years
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At this stage of life, many people do not consider cholesterol a threat, but experts recommend starting to have check-ups from the age of 20, especially if there are risk factors such as obesity, family history of early cardiovascular disease, hypertension or diabetes. According to medical guidelines, a test every four to six years is adequate to assess total cholesterol, LDL, HDL and triglyceride levels.
The most important thing in this age group is prevention through healthy habits: a diet rich in fiber and low in saturated fats, regular physical activity, maintaining a healthy weight and avoiding tobacco. In most cases, drug treatment is not required, except in patients with familial hypercholesterolemia or persistently elevated LDL levels.
Early intervention can prevent high cholesterol from becoming a serious problem in middle age. Atherosclerotic plaques form from youth, so acting now can have protective effects decades later.
From 40 to 75 years old
Between the ages of 40 and 75 is when cardiovascular risks increase significantly. At this stage, it is recommended not only to measure cholesterol, but also to calculate the 10-year cardiovascular risk, using validated tools such as the Framingham tables or the AHA risk calculators.
Statins have been shown to significantly reduce the incidence of heart attacks and cardiovascular events in this age group. In addition, the benefits tend to far outweigh the risks, especially in people with accumulated risk factors, but they are always prescribed by health specialists.
In people over 75 years of age without a history of cardiovascular disease, the evidence is less conclusive. In these cases, the decision should be individualized, taking into account life expectancy, functional status and tolerance to medication, according to the experts.