Below 40? You Should Already Be Getting Screened for Cholesterol, Heart Attack Risks
New medical guidelines aim to head off damage early with lifestyle changes, screening tests and medication.
New medical guidelines aim to head off damage early with lifestyle changes, screening tests and medication.
Adults should be screened and treated for high cholesterol starting at age 30, if not sooner, according to new clinical guidelines, lowering the age by at least a decade at a time when heart attacks are becoming more common in younger adults.
The goal is to shift to a more proactive approach to head off problems in younger years, rather than starting lifestyle changes and medical treatment in middle age when a patient may already have damage in their arteries, said Dr Roger Blumenthal, chair of the committee of cardiologists that wrote the new guidelines.
Growing research shows how much damage can be done when levels of LDL, or “bad,” cholesterol stay high in the blood for years, he said.
At the same time, more medicines have become available to lower cholesterol, along with screening tests and a new online tool that allows people 30 and older to calculate their risk of cardiovascular disease.
“We need to pay attention much earlier,” said Blumenthal, director of preventive cardiology at Johns Hopkins Medicine.
The guidelines, published Friday in two leading cardiology journals, were issued by 11 medical associations, including the American College of Cardiology and American Heart Association.
These organisations set standards for medical professionals from family doctors to cardiologists.
Approximately 25% of U.S. adults—and 20% of adolescents—have high LDL cholesterol.
For adults, especially, that increases their risk of heart attacks and strokes because it causes plaque-forming particles to build up in their arteries over time, hardening and narrowing them.
Doctors are being urged to counsel children and adolescents on diet and exercise, avoiding tobacco and other healthy lifestyle habits.
More young people are being diagnosed with diabetes and other conditions that put them at higher risk of cardiovascular events.
“If we want to talk about eliminating heart disease and heart attacks, treating cholesterol is one of the most important things,” said Dr Sadiya Khan, professor of cardiovascular epidemiology at Northwestern University Feinberg School of Medicine. She wasn’t involved in writing the recommendations.
The new guidelines offer a number of different ways doctors can determine whether a person’s at risk.
Everyone should get a blood test once to measure their levels of lipoprotein(a), another type of “bad” cholesterol linked to heart disease.
Researchers say Lp(a), which is genetic, significantly increases the risk of cardiovascular disease, and a test can identify risks for people who are otherwise healthy.
Testing for another protein, apolipoprotein B, can also be performed for those with high triglycerides, diabetes or other conditions, the guidelines say.
Research suggests it is a better predictor of heart disease risk than LDL cholesterol. undefined undefined Men aged 40 and older and women aged 45 and older with a borderline risk of heart attack or stroke may also get a coronary artery calcium scan to check for plaque buildup in arterial walls.
Children should be screened for cholesterol and other lipids once between ages 9 and 11, backing an existing recommendation by the American Academy of Pediatrics.
As part of the new guidelines, young adults should be screened beginning at age 19 and every five years after that.
People should be screened for their risk of cardiovascular disease starting at age 30, using an AHA online calculator called
Prevent that measures risk based on a person’s cholesterol, blood pressure, and other indicators. Screening was previously recommended beginning at age 40, using a different tool.
Young adults should be offered cholesterol-lowering medications if their LDL cholesterol is 160 milligrams per deciliter, according to the guidelines.
The same is true if they have a family history of atherosclerotic disease at an early age or a high risk of developing it over the next three decades as measured by the Prevent calculator.
Adults with genetically high cholesterol should also be put on medication. undefined undefined
While the end result of additional screening may mean more people end up on cholesterol-lowering drugs, younger people may be able to avoid high doses.
“If you identify someone at risk earlier in life, you may not need to treat them with as intensive a statin regimen because you have time on your side,” said Dr Steven Nissen, a preventive cardiologist at the Cleveland Clinic, who wasn’t involved in writing the new guidelines.
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A growing number of employers say Gen Z job seekers are bringing their parents into the hiring process, from attending interviews and negotiating offers to questioning performance reviews. Recruiters warn the trend may raise concerns about independence, even as some families see it as support in a challenging job market.
Steven Clark had the unpleasant task of firing a 24-year-old—twice. Once was in a brief conversation with the new hire, who’d showed up late or not at all four times in his first week at a construction job.
Then Clark had to do it all over again, this time with the guy’s mother.
She called him a few hours later, pleading to give her son another chance. When Clark told her no, things got heated before he ended the call.
“I said, ‘Look, you know, this is between us and your son. He’s the employee,’” says Clark, who is chief operating officer of a Fairbanks, Alaska-based staffing firm.
Gen Zers make up nearly one-fifth of the adult workforce, and bosses and recruiters say it often feels like the nervous parents who hovered over them through childhood and college are right alongside them. What began as the occasional parent ride-along to a job interview coming out of the Covid era is now full-on career “co-piloting,” said Jasmine Escalera, head career coach at résumé templates service Zety.
More parents are calling up hiring managers, applying for jobs on their adult child’s behalf, and even showing up—or lurking just off-screen—on Zoom calls to help navigate difficult conversations or go over benefits packages.
“The first time it happened, I was appalled,” says Clark, who has fielded calls from parents asking why their child didn’t get a job. “Since then it’s become more of a here-we-go-again reaction.”
Human resource professionals have expressed outrage on social media.
“Parents should not be calling employers to check on their application status or ask questions on behalf of their child,” says Lynne Alba, a director of talent acquisition and physician recruitment at a large health system on Long Island, who vented about the phenomenon in a Tik Tok video she reposted on LinkedIn.
At a recent job fair, a mother approached Alba with her daughter’s résumé, explaining that she wanted to work as a nurse. “While I appreciated that she was trying to help, I intentionally shifted my attention to her daughter. No matter what Mom said, I wanted to hear directly from the candidate,” says Alba.
Some parents who step in say it’s a challenging job market for young people, and that they would only intervene in extreme circumstances—social anxiety, a toxic boss, unfair treatment. There’s also a gray area of intervention that some see as an extension of the parental advice and networking help that’s been happening for generations.
Rick Wainschel last year published a post on LinkedIn asking his network to help his daughter, a recent college graduate, find a corporate entry-level position.
Wainschel, a vice president at an automotive marketing technology company, says he doesn’t think his outreach qualifies as helicoptering. “Well, maybe a little,” he said, before quickly adding he was being half tongue-in-cheek. “It was really merely just to help her get a network established. I just think the work world is a challenging place.”
Wainschel’s post, which was OK’d by his daughter on the condition he didn’t embarrass her, didn’t lead to a job but did result in productive conversations, he said. She found a job with a credit union on her own shortly after.
Recruiters and other HR types say aggressive parental involvement signals a lack of independence and raises fears that mom and dad will be checking in regularly if their kid gets hired.
What’s more, they say, such interference rarely, if ever, works.
The phenomenon is becoming so commonplace it made the agenda of human resources organization SHRM’s national conference in June. When James Harrell asked a room of 250 professionals if they ever had a parent calling on behalf of a young employee or coming to an interview, more than half raised their hands.
“The first time it happened to me, I got high up on my soapbox and I shook my fist,” Harrell says. “The 15th time I said, ‘OK, well, I gotta figure out how to do something differently.’”
Harrell helped run an apprenticeship program for high-school students while he was the human capital management chief for the San Antonio Independent School District. To run interference, the district introduced a “signing day” when parents could come and ask questions.
After a Gen Z employee at Nation’s Best Holdings, a chain of hardware and home goods stores, didn’t get an “exceeds expectations” designation on his performance review last year, HR chief Amber Little got a call asking why.
It was one of a number of calls from parents her office has picked up recently about issues ranging from negative feedback to understanding which health insurance plan to choose. Little has even noticed parents are now calling in sick for their adult kids.
“Instead of coaching them, they do it for them,” Little says. When it happens, she adds, “we encourage them to tell their child to come talk to us and we will walk them through it.”
A Zety survey of more than 1,000 Gen Zers found 20% had a parent attend a job interview with them.
“You get a sense it’s all hands on deck for some families,” says Keith Wolf, managing partner of recruiting firm Murray Resources in Houston. His office has received emails from parents seeking jobs for their children, and Wolf says he’s always wondered if the kids even knew.
Paul “PB” Branson, who graduated from the University of Missouri-Columbia in May, bristles at the thought. The 22-year-old says while he understands their anxiety, parents shouldn’t be joining their children’s job interviews or contacting employees on their behalf.
“That trend,” he says, “has really hurt my generation by creating this kind of stereotype that we need our hands held.”
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