{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T03:20:51Z","timestamp":1790047251658,"version":"4.0.1"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,3,19]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Although many studies on the association between dyslipidemia and cardiovascular disease (CVD) exist in older adults, data on the association among adolescents and young adults living with disproportionate burden of cardiometabolic disorders are scarce.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">The SHFS (Strong Heart Family Study) is a multicenter, family\u2010based, prospective cohort study of CVD in an American Indian populations, including 12 communities in central Arizona, southwestern Oklahoma, and the Dakotas. We evaluated SHFS participants, who were 15 to 39\u2009years old at the baseline examination in 2001 to 2003 (n=1440). Lipids were measured after a 12\u2010hour fast. We used carotid ultrasounds to detect plaque at baseline and follow\u2010up in 2006 to 2009 (median follow\u2010up=5.5\u2009years). We identified incident CVD events through 2020 with a median follow\u2010up of 18.5\u2009years. We used shared frailty proportional hazards models to assess the association between dyslipidemia and subclinical or clinical CVD, while controlling for covariates. Baseline dyslipidemia prevalence was 55.2%, 73.6%, and 78.0% for participants 15 to 19, 20 to 29, and 30 to 39\u2009years old, respectively. Approximately 2.8% had low\u2010density lipoprotein cholesterol \u2265160\u2009mg\/dL, which is higher than the recommended threshold for lifestyle or medical interventions in young adults of 20 to 39\u2009years old. During follow\u2010up, 9.9% had incident plaque (109\/1104 plaque\u2010free participants with baseline and follow\u2010up ultrasounds), 11.0% had plaque progression (128\/1165 with both baseline and follow\u2010up ultrasounds), and 9% had incident CVD (127\/1416 CVD\u2010free participants at baseline). Plaque incidence and progression were higher in participants with total cholesterol \u2265200\u2009mg\/dL, low\u2010density lipoprotein cholesterol \u2265160\u2009mg\/dL, or non\u2013high\u2010density lipoprotein cholesterol \u2265130\u2009mg\/dL, while controlling for covariates. CVD risk was independently associated with low\u2010density lipoprotein cholesterol \u2265160\u2009mg\/dL.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Dyslipidemia is a modifiable risk factor that is associated with both subclinical and clinical CVD, even among the younger American Indian population who have unexpectedly high rates of significant CVD events. Therefore, this population is likely to benefit from a variety of evidence\u2010based interventions including screening, educational, lifestyle, and guideline\u2010directed medical therapy at an early age.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.031741","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T10:07:56Z","timestamp":1709719676000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Dyslipidemia in American Indian Adolescents and Young Adults: Strong Heart Family Study"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6640-6543","authenticated-orcid":false,"given":"Jessica A.","family":"Reese","sequence":"first","affiliation":[{"name":"Center for American Indian Health Research, Department of Biostatistics and Epidemiology, Hudson College of Public Health University of Oklahoma Health Sciences Center Oklahoma City OK USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0183-6769","authenticated-orcid":false,"given":"Mary J.","family":"Roman","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason F.","family":"Deen","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Medicine University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9176-879X","authenticated-orcid":false,"given":"Tauqeer","family":"Ali","sequence":"additional","affiliation":[{"name":"Center for American Indian Health Research, Department of Biostatistics and Epidemiology, Hudson College of Public Health University of Oklahoma Health Sciences Center Oklahoma City OK USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2651-0127","authenticated-orcid":false,"given":"Shelley A.","family":"Cole","sequence":"additional","affiliation":[{"name":"Population Health Texas Biomedical Research Institute San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard B.","family":"Devereux","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5358-2345","authenticated-orcid":false,"given":"Amanda M.","family":"Fretts","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wm. James","family":"Howard","sequence":"additional","affiliation":[{"name":"Georgetown\u2010Howard Universities Center for Clinical and Translational Science Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1826-3602","authenticated-orcid":false,"given":"Elisa T.","family":"Lee","sequence":"additional","affiliation":[{"name":"Center for American Indian Health Research, Department of Biostatistics and Epidemiology, Hudson College of Public Health University of Oklahoma Health Sciences Center Oklahoma City OK USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Malloy","sequence":"additional","affiliation":[{"name":"Center for American Indian Health Research, Department of Biostatistics and Epidemiology, Hudson College of Public Health University of Oklahoma Health Sciences Center Oklahoma City OK USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2746-3350","authenticated-orcid":false,"given":"Jason G.","family":"Umans","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute Hyattsville MD USA"},{"name":"Georgetown\u2010Howard Universities Center for Clinical and Translational Science Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6945-3743","authenticated-orcid":false,"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center for American Indian Health Research, Department of Biostatistics and Epidemiology, Hudson College of Public Health University of Oklahoma Health Sciences Center Oklahoma City OK USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-1958"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1619"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000950"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.99.18.2389"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-2110"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.108.772285"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.05.002"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejm199908123410707"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000625"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.14.1678"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/hco.0000000000000211"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-2107C"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2022.04.024"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2109191"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.4984"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2018.01.022"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwf208"},{"key":"e_1_3_1_19_2","unstructured":"Supplemental information to the NIH policy for data management and sharing: responsible management and sharing of American Indian\/Alaska Native participant data. 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