{"product_id":"should-healthy-young-adults-take-statins-the-debate-over-starting-cholesterol-medication-early-in-life","title":"Should Healthy Young Adults Take Statins? The Debate Over Starting Cholesterol Medication Early in Life","description":"\u003cp\u003eThis expert commentary from the \u003cem\u003eJournal of the American College of Cardiology\u003c\/em\u003e examines a controversial question in preventive medicine: Should healthy young adults start taking cholesterol-lowering statin medications decades before they would normally need them? While two accompanying articles argue that starting statins early could prevent heart disease by stopping artery damage before it accumulates, this analysis by Drs. Mark J. Pletcher and Stephen B. Hulley from the University of California, San Francisco, carefully weighs the many uncertainties around benefits, harms, and costs. The authors conclude that the evidence is not yet strong enough to recommend widespread statin use in young adults, and they outline a research agenda to resolve these questions before guidelines are expanded.\u003c\/p\u003e\n\n\u003ch1\u003eShould Healthy Young Adults Take Statins? The Debate Over Starting Cholesterol Medication Early in Life\u003c\/h1\u003e\n\n\u003ch2\u003eTable of Contents\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003e\u003ca href=\"#ddn-key-points\"\u003eKey Points\u003c\/a\u003e\u003c\/li\u003e\n\n  \u003cli\u003e\u003ca href=\"#background\"\u003eBackground: Why This Debate Matters\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#case-for-early\"\u003eThe Case for Early Treatment: The \"Cumulative Damage\" Hypothesis\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#uncertain-benefits\"\u003eUncertain Benefits: Will Early Statins Actually Prevent Heart Attacks?\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#uncertain-harms\"\u003eUncertain Harms: The Risks of Lifelong Statin Use\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#uncertain-costs\"\u003eUncertain Costs: Can We Afford to Treat Everyone?\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#bottom-line\"\u003eThe Bottom Line: What Do the Authors Recommend?\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#limitations\"\u003eLimitations: What This Analysis Could Not Prove\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#ddn-faq\"\u003eFrequently Asked Questions\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#source\"\u003eSource Information\u003c\/a\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003c!-- ddn:keypoints:start --\u003e\n\u003ch2 id=\"ddn-key-points\"\u003eKey Points\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003eStarting statins in young adults is controversial; current guidelines only recommend them after lifestyle changes fail and for rare genetic conditions.\u003c\/li\u003e\n\u003cli\u003eGenetic lifelong low LDL is linked to 88% lower heart disease risk, versus 20–40% with midlife statins.\u003c\/li\u003e\n\u003cli\u003eUncertain long-term harms include possible higher diabetes risk—nearly 5% extra cumulative risk over 50 years if linear.\u003c\/li\u003e\n\u003cli\u003eStarting statins at age 30 may be too late because artery damage already begins in childhood or young adulthood.\u003c\/li\u003e\n\u003cli\u003eThe authors suggest incremental guideline expansion for high-lifetime-risk young adults and call for more research.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c!-- ddn:keypoints:end --\u003e\n\n\n\u003ch2 id=\"background\"\u003eBackground: Why This Debate Matters\u003c\/h2\u003e\n\n\u003cp\u003eCoronary heart disease (CHD) — the buildup of fatty plaque in the arteries that supply the heart — remains one of the nation's leading killers. For decades, doctors have used statin medications to lower cholesterol and reduce heart attack risk in middle-aged and older adults. But a much more provocative question has emerged: What if we started giving statins to people in their twenties and thirties, long before any signs of heart disease appear?\u003c\/p\u003e\n\n\u003cp\u003eYoung adults below 35 years of age who do not have an exceedingly rare genetic disorder such as familial hypercholesterolemia (a condition causing dangerously high cholesterol from birth) are at very low short-term risk — meaning within 5 to 10 years — for coronary heart disease. Current guidelines from the National Cholesterol Education Program's Adult Treatment Panel are correspondingly conservative. They recommend drug therapy with statins in this age group only if cholesterol levels remain very high after a genuine trial of lifestyle modification such as diet and exercise.\u003c\/p\u003e\n\n\u003cp\u003eBut in this same issue of the journal, two separate reports by Dr. Steinberg and Dr. Forrester press for earlier and more aggressive treatment with statins, particularly for young adults who have high \u003cem\u003elifetime\u003c\/em\u003e risk even if their 10-year risk is low. Their argument has three parts: 1) atherosclerotic damage to coronary arteries from nonoptimal lipid levels starts accumulating early in life; 2) this damage could be prevented or slowed with statin therapy; and 3) preventing the accumulation of atherosclerotic damage should lead to much lower rates of cardiovascular disease later in life.\u003c\/p\u003e\n\n\u003cp\u003eThis commentary by Pletcher and Hulley pushes back on that enthusiasm. Expanding statin therapy to include young persons with low short-term risk, they argue, is a \"high-stakes proposition\" that could result in many millions of healthy young adults starting lifelong statin therapy. They discuss the uncertainties about the potential benefits, harms, and costs of this approach — a set of difficult decisions the Adult Treatment Panel IV committee had to address in its fourth report, due in early 2011.\u003c\/p\u003e\n\n\u003ch2 id=\"case-for-early\"\u003eThe Case for Early Treatment: The \"Cumulative Damage\" Hypothesis\u003c\/h2\u003e\n\n\u003cp\u003eThe rationale for starting statins early rests on the \"cumulative damage hypothesis.\" Multiple lines of evidence support the idea that the longer your arteries are exposed to high cholesterol, the more damage accumulates — and that preventing that damage early could pay off decades later.\u003c\/p\u003e\n\n\u003cp\u003eThree key lines of evidence support this hypothesis. First, statin treatment initiated in middle-aged and older populations can arrest and even reverse atherosclerosis (the hardening and narrowing of arteries), as demonstrated in several trials (references 4–6). Second, atherosclerosis itself is a strong predictor of future heart attacks, so preventing it should logically prevent heart disease. And third, genetic research has revealed something remarkable: people born with genetic variations that keep their LDL cholesterol low their entire lives appear to be almost completely protected from heart disease.\u003c\/p\u003e\n\n\u003cp\u003eThe genetic evidence is particularly striking. Studies of the PCSK9 gene — which controls expression of the LDL particle receptor, the protein that removes \"bad\" LDL cholesterol from the blood — show that people with genetic variations that reduce LDL over a lifetime experience an \u003cstrong\u003e88% relative risk reduction\u003c\/strong\u003e in coronary heart disease. Contrast this with the typical 20% to 40% reduction in heart attack risk achieved when statins are started in middle age or later. The dramatic difference suggests that the \u003cem\u003eduration\u003c\/em\u003e of LDL exposure matters enormously — and that reducing LDL earlier in life might provide far more complete protection than starting treatment later.\u003c\/p\u003e\n\n\u003cp\u003eAdditional support comes from the CARDIA cohort study (Coronary Artery Risk Development in Young Adults), which the authors themselves conducted. That study found a very low prevalence of coronary calcium — a marker of early atherosclerosis visible on CT scans — in middle-aged people who had maintained low levels of LDL cholesterol since they were in their twenties. In other words, keeping cholesterol low from young adulthood onward appears to keep arteries clean decades later.\u003c\/p\u003e\n\n\u003ch2 id=\"uncertain-benefits\"\u003eUncertain Benefits: Will Early Statins Actually Prevent Heart Attacks?\u003c\/h2\u003e\n\n\u003cp\u003eDespite the appeal of the cumulative damage hypothesis, the authors identify several important reasons to doubt that simply starting statins at age 30 will deliver the expected benefits.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eFirst, drug-induced LDL reduction may not equal genetic LDL reduction.\u003c\/strong\u003e The near-total protection seen in people with PCSK9 gene variations is lifelong and may involve other biological effects beyond just lowering cholesterol. Statins certainly reduce atherosclerotic disease early in life in some settings — for example, in children with familial hypercholesterolemia — but there is no hard evidence from long-term randomized trials that statin therapy started in young adulthood produces the same benefits as lifelong genetic protection.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eSecond, starting at age 30 may simply be too late.\u003c\/strong\u003e As suggested by Steinberg, beginning statins at age 30 means the arteries have already been exposed to three decades of nonoptimal LDL levels. Primordial atherosclerotic changes are evident early in life — even in children and young adults, as shown in the Bogalusa Heart Study (reference 14). Starting after 30 years of exposure might provide only modest incremental improvement in terms of atherosclerosis reduction and long-term heart attack protection.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eThird, and perhaps most importantly, statins work in middle-aged adults faster than the \"plaque prevention\" theory would predict.\u003c\/strong\u003e Randomized trials in middle-aged and older populations reveal that CHD event prevention starts quickly, within 1 to 2 years of initiating statin therapy. This rapid benefit cannot be explained solely by the slow process of atherosclerosis reversal. Instead, it suggests that a substantial component of statin efficacy comes from what researchers call \u003cem\u003e\"pleiotropic\" mechanisms\u003c\/em\u003e — short-term effects like plaque stabilization and anti-inflammatory actions that are not directly related to arresting the long-term progression of atherosclerosis. To the extent that these short-term nonatherosclerotic mechanisms drive statin benefits, starting treatment early in life may not provide the expected degree of benefit compared with simply deferring treatment until later in life, when heart attack risk actually begins to rise.\u003c\/p\u003e\n\n\u003cp\u003eThere are also two practical barriers that could undermine hoped-for benefits: adherence. Both physicians and patients are known to be poor at following long-term preventive medication guidelines. Studies show this is already a substantial problem in older adults at high risk, and the situation is worse at younger ages. The same problem arises with efforts to control hypertension (high blood pressure) in young adults. The authors suggest that mounting efforts to improve adherence to existing guidelines in people at moderate to high short-term risk is probably a more efficient, immediate, and noncontroversial public health strategy than expanding prescribing guidelines into younger age groups — though they note the two approaches are not mutually exclusive.\u003c\/p\u003e\n\n\u003ch2 id=\"uncertain-harms\"\u003eUncertain Harms: The Risks of Lifelong Statin Use\u003c\/h2\u003e\n\n\u003cp\u003eStatins are relatively safe medications, and serious side effects are rare. But \"relatively safe over 5 years\" is different from \"safe over 50 years,\" and the authors carefully itemize what is known — and not known — about long-term risks.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eKnown risks in middle-aged and older adults include:\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul\u003e\n  \u003cli\u003e\n\u003cstrong\u003eRhabdomyolysis\u003c\/strong\u003e — the most serious, though exceedingly rare, side effect, involving severe muscle breakdown that can damage the kidneys. It is estimated from large observational post-marketing studies to occur at a rate of \u003cstrong\u003e3 to 4 per 100,000 person-years of treatment\u003c\/strong\u003e, with about 10% of cases being fatal.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eClinically significant myopathy\u003c\/strong\u003e — muscle pain or weakness accompanied by elevated creatine kinase (a muscle enzyme in the blood) — occurs at an excess rate of about \u003cstrong\u003e11 per 100,000 person-years\u003c\/strong\u003e in statin users.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eMinor muscle pain (myalgia)\u003c\/strong\u003e — reported commonly by statin users, but interestingly, this symptom appears just as common in people randomized to placebo as in those randomized to statins in controlled trials, suggesting some of it may not be caused by the medication.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eElevated liver enzymes\u003c\/strong\u003e — persistently elevated serum levels of alanine aminotransferase (ALT, a liver enzyme) occur at an excess rate of about \u003cstrong\u003e70 per 100,000 person-years\u003c\/strong\u003e. However, no firm evidence links statin use to actual liver damage, and rates of liver failure in statin users are indistinguishable from background rates in the general population.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003ePeripheral neuropathy\u003c\/strong\u003e — nerve damage causing tingling or numbness, reported at a rate of \u003cstrong\u003e12 per 100,000 person-years\u003c\/strong\u003e.\u003c\/li\u003e\n  \u003cli\u003e\n\u003cstrong\u003eNew-onset diabetes\u003c\/strong\u003e — a surprising and significant finding from a meta-analysis of randomized trials: an excess rate of about \u003cstrong\u003e1 in 255 persons\u003c\/strong\u003e taking statins for 4 years developed diabetes attributable to the medication.\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eEarly concerns about increased rates of cancer, suicide, or depression associated with low cholesterol levels or statin use have not been substantiated by large meta-analyses, longer-term follow-up (10 years or more) from several clinical trials, and other recent studies.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eBut major uncertainties remain.\u003c\/strong\u003e The authors emphasize that the dearth of long-term follow-up in statin trials makes it unclear whether cumulative risk for adverse effects increases with each additional year of treatment. Consider the diabetes finding: does the excess diabetes risk stay at 1 in 255 persons for treatment courses longer than 4 years, or does it continue to accrue? If risk continues to accrue at the same rate — about \u003cstrong\u003e1 per 1,000 person-years of treatment\u003c\/strong\u003e — then the excess cumulative risk for diabetes after 50 years of treatment (for example, from age 30 to age 80) would approach \u003cstrong\u003e5%\u003c\/strong\u003e, which translates to a number needed to harm of about 21 (meaning 21 people would need to be treated for 50 years to cause one additional case of diabetes). That would partially counterbalance the expected benefits of statin therapy.\u003c\/p\u003e\n\n\u003cp\u003eSimilarly, if the annual rate of statin-associated rhabdomyolysis does not decrease after the first few years but instead continues unabated — or even increases — with longer-term exposure, then several decades of treatment could cause a much higher cumulative risk for this life-threatening condition than is currently seen in practice.\u003c\/p\u003e\n\n\u003cp\u003eThe authors also raise concerns specific to young adults. They know of no reason why statins should be more toxic in young adults than in older adults — but young adults are physiologically different. It would not be surprising, they write, if myopathy or minor muscle pain turned out to be more common in young adults, or if young adults were susceptible to some yet-undiscovered adverse effect. Young women who may become pregnant are a special case: statins are not considered safe to take during pregnancy or breastfeeding, and this could complicate efforts to extend statin prescribing to young women of childbearing age.\u003c\/p\u003e\n\n\u003cp\u003eFinally, taking a statin every day for many decades may have subtler quality-of-life consequences. It can alter self-image by \u003cem\u003e\"labeling\"\u003c\/em\u003e a person as less than healthy, induce excessive concern about future heart disease, or otherwise dampen quality of life. This is likely to be especially important for young adults who might otherwise have no regular contact with the medical world. When substantial levels of this \"disutility\" are present and persistent, they can outweigh the benefits of statin therapy — particularly because those benefits are remote in time and therefore subject to \u003cem\u003e\"discounting,\"\u003c\/em\u003e the well-documented concept that people tend to value current events more highly than those in the distant future. On the other hand, disutility may wane over time as users become accustomed to taking a pill every day, and education about the benefits of the medication may substantially reduce or even reverse this effect.\u003c\/p\u003e\n\n\u003ch2 id=\"uncertain-costs\"\u003eUncertain Costs: Can We Afford to Treat Everyone?\u003c\/h2\u003e\n\n\u003cp\u003eThe cost of statins has become less of a limiting factor since generic formulations became widely available. In one cost-effectiveness analysis, treating all persons age 35 and older with LDL levels of 130 mg\/dl or higher became \u003cstrong\u003ecost-saving\u003c\/strong\u003e — meaning the savings from prevented heart attack events outweighed the costs of the medication — when the cost of statins was $0.10 per pill or less.\u003c\/p\u003e\n\n\u003cp\u003ePer-pill costs in this range are currently available through large discount chains, although prices at retail pharmacies are often substantially higher, even for generic formulations. The authors emphasize several scenarios that could make a major initiative to expand statin prescribing for low-risk young adults expensive and potentially fail standard cost-effectiveness thresholds:\u003c\/p\u003e\n\u003cul\u003e\n  \u003cli\u003eIf very low prices for statins cannot be universally accessed by the public\u003c\/li\u003e\n  \u003cli\u003eIf average prices rise significantly\u003c\/li\u003e\n  \u003cli\u003eIf high-cost brand-name formulations are used instead of generics\u003c\/li\u003e\n  \u003cli\u003eIf the added cost of starting statins earlier in life is not sufficiently offset by enhanced reductions in heart attack rates\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003ch2 id=\"bottom-line\"\u003eThe Bottom Line: What Do the Authors Recommend?\u003c\/h2\u003e\n\n\u003cp\u003eSo how should the Adult Treatment Panel IV committee weigh these uncertainties against mounting evidence that supports expanding statin prescribing to young adults? The authors present two possible paths forward.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003ePath one: Wait for more research.\u003c\/strong\u003e Waiting for more research before expanding statin prescribing guidelines is a reasonable option, they argue. Although the ideal randomized trial — one that follows young adults for decades — is essentially impossible because of the extraordinarily long follow-up time required, other types of research could meaningfully inform the decision:\u003c\/p\u003e\n\u003col\u003e\n  \u003cli\u003eFurther observational research on long-term effects, both harms and benefits\u003c\/li\u003e\n  \u003cli\u003eConfirmation of the genetically mediated lifelong cholesterol exposure findings\u003c\/li\u003e\n  \u003cli\u003eRandomized trials to explore short-term effects in young adults\u003c\/li\u003e\n  \u003cli\u003eTrials to improve adherence to guidelines by both physicians and patients\u003c\/li\u003e\n  \u003cli\u003eModeling studies to quantify uncertainty and simulate the projected effects of different statin prescribing strategies\u003c\/li\u003e\n\u003c\/ol\u003e\n\n\u003cp\u003eThis important research should proceed regardless of how guidelines are formulated next year, the authors insist.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003ePath two: Expand guidelines incrementally.\u003c\/strong\u003e If the committee does decide to expand treatment guidelines, the approach advocated by Steinberg and Forrester is a reasonable next step: \u003cstrong\u003econsider statins for younger persons, perhaps starting at age 30, but only for those with risk factors that convey high lifetime risk\u003c\/strong\u003e (as opposed to 10-year risk) for coronary heart disease. Treating high-risk persons who have more to gain in the long run increases the likelihood that treatment will eventually result in net benefit for patients.\u003c\/p\u003e\n\n\u003cp\u003eHowever, the authors caution that this \"high-risk only\" approach would have limited population-level impact. Because many heart attack events actually occur in the more numerous lower-risk people, treating only high-risk young adults would fall short of the dramatic vision proposed by Forrester of \"unseating coronary disease as the nation's leading killer.\" Achieving that goal would require a much more dramatic expansion of treatment guidelines — including treating young adults with lower lifetime risk — along with excellent adherence by both doctors and patients.\u003c\/p\u003e\n\n\u003cp\u003eSuch a dramatic expansion in statin prescribing would expose many more people to the uncertain benefits, harms, and costs of lifelong statin therapy. For this reason, the authors recommend that any expansion be approached \u003cstrong\u003eincrementally\u003c\/strong\u003e by future guidelines, allowing the evidence base to grow alongside clinical practice.\u003c\/p\u003e\n\n\u003ch2 id=\"limitations\"\u003eLimitations: What This Analysis Could Not Prove\u003c\/h2\u003e\n\n\u003cp\u003eThis is a commentary article, not a clinical trial, so it offers expert interpretation rather than new experimental data. The authors themselves note several important limitations of the available evidence. The ideal randomized trial — starting statins in young adults and following them for 50 to 60 years until heart attacks occur — has never been done and is essentially impossible to conduct due to cost, feasibility, and the impracticality of maintaining blinded treatment for decades. Long-term safety data beyond 10 years of statin use are extremely limited. The diabetes risk projection (approaching 5% cumulative risk over 50 years) is an extrapolation based on the assumption that risk accrues linearly, which may not be accurate. And the cost-effectiveness calculations are based on specific pricing assumptions that may not hold in real-world practice.\u003c\/p\u003e\n\n\u003cp\u003eIt is also worth noting that this article was published in 2010. Since then, new guidelines, new statin options, and additional safety and effectiveness data have emerged. However, the core uncertainties the authors identified — the value of lifelong statin therapy starting in young adulthood, the diabetes risk question, adherence challenges, and cost considerations — remain relevant to today's clinical debates. The methodological framework of carefully weighing uncertain benefits against uncertain harms before expanding preventive treatment to large populations is timeless.\u003c\/p\u003e\n\n\u003c!-- ddn:faq:start --\u003e\n\u003ch2 id=\"ddn-faq\"\u003eFrequently Asked Questions\u003c\/h2\u003e\n\u003ch3\u003eShould healthy young adults start taking statins to prevent future heart disease?\u003c\/h3\u003e\n\u003cp\u003eExperts disagree. Some argue starting statins in the twenties or thirties could prevent artery damage before it accumulates. However, this commentary highlights many uncertainties about benefits, harms, and costs. Current guidelines recommend statins for young adults only if cholesterol remains very high after diet and exercise, except for rare genetic conditions like familial hypercholesterolemia.\u003c\/p\u003e\n\u003ch3\u003eWhat is the cumulative damage hypothesis for cholesterol and heart disease?\u003c\/h3\u003e\n\u003cp\u003eIt proposes that longer exposure of arteries to high cholesterol causes more damage over time, and preventing that damage early could reduce heart disease decades later. Evidence includes genetic studies showing people born with lifelong low LDL have 88% lower heart disease risk, whereas statins started in middle age reduce risk by only 20% to 40%.\u003c\/p\u003e\n\u003ch3\u003eHow do the risks of lifelong statin use compare to short-term use?\u003c\/h3\u003e\n\u003cp\u003eStatins are relatively safe over five years, but effects over fifty years are uncertain. Known risks include very rare rhabdomyolysis, muscle pain, elevated liver enzymes, and new-onset diabetes. For diabetes, about 1 in 255 people on statins for 4 years develops it; if this continues, 50 years of treatment could lead to nearly 5% extra risk.\u003c\/p\u003e\n\u003ch3\u003eDoes lifelong genetic protection against high cholesterol work better than statins?\u003c\/h3\u003e\n\u003cp\u003eYes, genetic studies show people with variations that keep LDL low their entire lives have an 88% reduction in coronary heart disease risk. This is much greater than the 20%–40% reduction from statins started in middle age. This difference suggests how long LDL is low matters, but statins may not replicate lifelong genetic effects exactly.\u003c\/p\u003e\n\u003ch3\u003eWhy might starting statins at age 30 be too late to fully prevent heart disease?\u003c\/h3\u003e\n\u003cp\u003eBecause arteries have already been exposed to nonoptimal LDL levels for three decades, and early atherosclerotic changes are visible even in children and young adults. Starting at age 30 may only provide modest improvement compared with lifelong low LDL. Also, statins help middle-aged adults quickly through other mechanisms, so early treatment might not add much benefit.\u003c\/p\u003e\n\u003ch3\u003eWhat do the authors recommend for expanding statin use in young adults?\u003c\/h3\u003e\n\u003cp\u003eThey advise caution. If guidelines expand, they suggest treating younger persons, perhaps starting at age 30, but only those with high lifetime risk—not low 10-year risk. They also urge more research on long-term harms, benefits, adherence, and costs before widespread use. Treating only high-risk young adults would have limited population impact, however.\u003c\/p\u003e\n\u003ch3\u003eCan young women take statins if they might become pregnant?\u003c\/h3\u003e\n\u003cp\u003eNo, statins are not considered safe to take during pregnancy or breastfeeding. This complicates efforts to prescribe statins to young women of childbearing age, according to the article. Doctors and patients need to discuss contraception and family planning if statin therapy is considered.\u003c\/p\u003e\n\u003c!-- ddn:faq:end --\u003e\n\n\u003ch2 id=\"source\"\u003eSource Information\u003c\/h2\u003e\n\n\u003cp\u003e\u003cstrong\u003eOriginal article:\u003c\/strong\u003e \"Statin Therapy in Young Adults: Ready for Prime Time?\" — a commentary by Mark J. Pletcher, MD, MPH, and Stephen B. Hulley, MD, MPH, from the Department of Epidemiology and Biostatistics and the Division of General Internal Medicine, Department of Medicine, University of California, San Francisco.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003ePublication:\u003c\/strong\u003e \u003cem\u003eJournal of the American College of Cardiology\u003c\/em\u003e, Vol. 56, No. 8, 2010, pages 637–640. Published by Elsevier Inc. on behalf of the American College of Cardiology Foundation. DOI: 10.1016\/j.jacc.2010.05.018. Received April 19, 2010; accepted May 4, 2010.\u003c\/p\u003e\n\n\u003cp\u003eThe authors reported no relationships to disclose. The article references 37 prior studies, including clinical trials, meta-analyses, and observational research from the CARDIA cohort, the Bogalusa Heart Study, and major international statin trials.\u003c\/p\u003e\n\n\u003cp\u003e\u003cem\u003eNote: This patient-friendly article is based on peer-reviewed research. It is provided for educational purposes and is not a substitute for professional medical advice. Individuals considering statin therapy should discuss the risks and benefits with their healthcare provider.\u003c\/em\u003e\u003c\/p\u003e","brand":"DiagnosticDetectives.Com","offers":[{"title":"Default Title","offer_id":47458591015068,"sku":null,"price":0.0,"currency_code":"EUR","in_stock":true}],"url":"https:\/\/diagnosticdetectives.de\/products\/should-healthy-young-adults-take-statins-the-debate-over-starting-cholesterol-medication-early-in-life","provider":"DiagnosticDetectives.Com","version":"1.0","type":"link"}