From a groundbreaking study by the Strong Heart Family Study (SHFS), researchers have uncovered alarmingly high levels of dyslipidemia, a condition characterized by abnormal amounts of cholesterol in the blood, among Native American adolescents and young adults. The study, encompassing participants aged 15 to 39 from 12 communities across central Arizona, southwestern Oklahoma, and the Dakotas, highlights a concerning trend that could have significant implications for the future health of this population.

Conducted between 2001 and 2020, the study observed over 1,400 individuals, revealing that the prevalence of dyslipidemia was staggeringly high across all age groups studied. Young people aged 15 to 19 had a prevalence rate of 55.2%, which increased to 73.6% for those aged 20 to 29, and 78.0% for the 30 to 39 age group. These findings are particularly worrying given the link between dyslipidemia and cardiovascular diseases (CVD), which are the leading cause of death in the United States.

The study utilized thorough methods to assess participants, including lipid measurements after a 12-hour fast and carotid ultrasounds to detect plaque, which is a key indicator of cardiovascular risk. Over the nearly two decades of follow-up, the researchers identified a significant association between high cholesterol levels and the incidence of plaque and cardiovascular disease.

Alarmingly, despite the known risks, very few of the participants with high levels of LDL cholesterol (often referred to as “bad” cholesterol) were on lipid-lowering medications. This gap in treatment underscores the need for more aggressive screening and management strategies within this population to prevent the onset of cardiovascular disease at a younger age.

“We were surprised about the numbers, especially in adolescents,” said Jessica A. Reese, Ph.D., an epidemiologist in the Center for American Indian Health Research at the University of Oklahoma Health Sciences Center, Oklahoma City. “These findings show the importance of early screenings and interventions, especially for teens and young adults who may be more likely to have underlying cardiovascular risks, diabetes, or chronic liver disease.”

This study is the first of its kind to document the burden of dyslipidemia in Native American youth, providing a crucial insight into a population that is often underrepresented in medical research. The findings underscore the urgent need for evidence-based interventions, including lifestyle modifications and medical therapies, to address this modifiable risk factor for cardiovascular disease.

“This research supports efforts to identify ways, such as increased screenings and culturally relevant education, to improve heart health and support younger generations of Native Americans,” said Mona Puggal, M.P.H., an epidemiologist in the Division of Cardiovascular Sciences at the National Heart, Lung, and Blood Institute (NHLBI), part of NIH.

Moreover, the study’s conclusions call for a concerted effort to raise awareness about the importance of cholesterol management from a young age, particularly in populations with a high burden of cardiometabolic disorders. With cardiovascular disease being such a significant health challenge, early intervention could play a crucial role in improving long-term health outcomes for Native American youth.

“It’s important for everyone to work with their physician to annually check their blood cholesterol and blood sugar, which can support a healthy life later on,” said Ying Zhang, M.D., Ph.D., Director at the Center for American Indian Health Research at the University of Oklahoma Health Sciences Center. “It’s also vital that annual care is coordinated as youth mature from seeing pediatricians to adult health care providers.”

As this research sheds light on a critical public health issue, it also emphasizes the importance of inclusive health studies that can inform targeted interventions to support the health and well-being of Native American communities.