Prevalence and Correlates of Coronary Artery Disease among community-dwelling Young Adults in the United States

Background: Data regarding the burden of coronary artery disease (CAD) in the young in the United States is sparse. We sought to estimate the prevalence of CAD, as well as its correlates among young adults.

Methods: We abstracted data from the National Health and Nutrition Examination Survey of 9,802 adults aged 20-44 years, from 2005-2012. Age-adjusted population-based CAD prevalence rates based on self-reports of prior diagnosis with CAD or myocardial infarction were computed. Multivariable logistic regression was utilized to examine the association between CAD and: sociodemographic variables, history of cocaine and marijuana use, smoking history, secondhand smoking, BMI, high density lipoprotein (HDL) cholesterol, hypertension, and diabetes mellitus. Survey weights were applied, and odds ratios (OR), and confidence intervals (CI) were computed.

Results: The age-adjusted prevalence of CAD among those aged 20-44 years was less than 1% (0.79%; 95% CI 0.56-1.02) and was statistically non-different between males and females. In multivariable analysis, increased odds of CAD were seen with: being underweight (OR: 6.98; 95% CI 1.17-38.24); diabetes mellitus (OR: 5.28; 95% CI 1.45-19.21); hypertension (OR: 3.89; 95% CI 1.24-12.18); a life-time smoking history of at least 100 cigarettes (OR: 3.10; 95% CI 1.29, 7.39); and low HDL (OR: 2.95; 95% CI 1.25-6.97).  

Conclusion: In addition to the traditional risk factors, CAD may be associated with being underweight, albeit among those aged 20-44 years. Prospective studies are needed to clarify the nature of the relationship between CAD and non-traditional risk factors such as being underweight in this age group.