Lipid disorders: Why young adults are suffering heart attacks

A team of medics performing CPR and inserting an IV drip on a patient lying unconscious in a hospital bed. [iStockphoto] When 19-year-old *Jeffrey walked into Aga Khan Hospital after suffering a heart attack, doctors were not entirely surprised. Having lost his father to a heart attack at just 43 years old last year, Jeffrey's case highlights a growing health crisis that knows no age bounds. "I thought I was too young for heart attacks," Jeffrey said, echoing a dangerous misconception about cardiovascular health. Lipid Specialist Dr Mzee Ngunga a leading cardiologist at Aga Khan University Hospital, emphasized that cholesterol disorders often strike silently, with no visible symptoms until a catastrophic event occurs. "Lipidology is a study of lipids and the disorders associated with it," he said. "Lipids play a crucial role in cardiovascular health, as they are primary contributors to several serious conditions," explains the cardiologist. "The most significant is coronary artery disease, where lipid buildup causes blockages in the heart's arteries. These blockages can lead to heart attacks or angina-chest pain that occurs during physical activities like walking or jogging due to reduced blood flow to the heart." The cardiologist further notes that lipid disorders can lead to three major cardiovascular conditions. First is heart disease, resulting in heart attacks. Second is cerebrovascular disease, where blocked arteries in the brain can form blood clots. Third is peripheral artery disease, which affects blood vessels outside the heart and brain. Lifestyle factors Peripheral artery disease occurs when arteries in the legs become blocked, leading to symptoms like claudication-pain that develops while walking. Patients may also develop wounds or ulcers in their lower legs. While cholesterol disorders are common across the population, they become particularly dangerous in certain groups. The International Atherosclerosis Society describes lipid disorders as abnormalities in blood fats that can significantly increase the risk of heart disease and stroke. These conditions can be inherited or develop due to lifestyle factors, making regular screening essential for early detection and management. The conditions become more severe in elderly patients and those with underlying health issues like diabetes. Smoking is another significant risk factor-when combined with high cholesterol, it can accelerate the development of complications. Diabetes and hypertension can intensify the effects of cholesterol disorders. Dr Ngunga explains that lipid disorders are often misunderstood yet potentially deadly conditions. "Many people don't realize that cholesterol problems aren't just about being overweight," he says. "We see lean patients with dangerous cholesterol levels and larger patients with normal readings. It's crucial to understand that genetics play a significant role." Despite the serious nature of cholesterol problems, they often receive less attention than related conditions like hypertension or diabetes. While patients regularly visit specialized clinics for these conditions, cholesterol disorders-which are actually the primary driver of arterial disease-frequently go overlooked. Though hypertension acts as a catalyst, elevated cholesterol levels are the main underlying concern. "If you're having a heart attack at 40, your cholesterol problem likely started when you were 19 or 20," Dr Ngunga says. "It's a cumulative disease that builds up over time." "These disorders can affect people of all ages," says the cardiologist. He adds: "In my experience as a cardiologist, I've treated heart attack patients ranging from 19 to 104 years old." In younger patients, Dr Ngunga says heart attacks often stem from familial hyperlipidemia, an inherited condition that elevates cholesterol levels beginning in childhood. "The insidious nature of this condition makes it especially concerning," he adds. "Most patients remain unaware they have it until they suffer a cardiac event. It's often a devastating shock when people in their 20s and 30s learn they have this condition, as they'd never noticed any warning signs." Recent studies by the African Heart Network indicate that approximately 30 per cent of urban Kenyan adults have elevated cholesterol levels, yet fewer than 15 per cent are aware of their condition. This awareness gap has prompted the establishment of Kenya's pioneering lipid clinic. "Our goal is not just to treat patients but to create a comprehensive support system for both healthcare providers and the public," says Dr Ngunga. To combat this growing health challenge, the clinic is spearheading the formation of the Kenya Lipidology Society. This initiative aims to improve access to testing and treatment through advocacy and education. "We need to make these essential tests more affordable and accessible," emphasises Dr Ngunga. "Prevention and early intervention are key to reducing the burden of cardiovascular disease." The clinic's establishment aligns with WHO's global targets for non-communicable disease prevention, which include reducing raised cholesterol prevalence by 25 per cent by 2026. Achievement of this goal requires improved access to screening, medication, and lifestyle interventions.

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