{"id":"34509fba69b2","type":"article","url":"https://hartvaat.nl/2026/12/01/vroegtijdige-ascvd-bij-jongeren-preventie-richt-zich-op-cumulatieve-risicobloots/","title":"Vroegtijdige ASCVD bij jongeren: preventie richt zich op cumulatieve risicoblootstelling","title_en":"Early-onset atherosclerotic cardiovascular disease in young adults: Lifestyle, environmental, and psychosocial risk factors.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["huisarts","internist"],"tags":[],"journal":"International journal of cardiology. Cardiovascular risk and prevention","doi":"10.1016/j.ijcrp.2026.200714","source_url":"https://doi.org/10.1016/j.ijcrp.2026.200714","authors":["Tukhtaeva Nigora Khasanovna","Babajanov Xudoybergan Egamberdi Son"],"significance":5,"published":"2026-10-14","source_date":"2026-12-01","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/"],"congress":"","summary_en":"This narrative review examines the lifestyle, environmental, metabolic, and psychosocial determinants of early-onset atherosclerotic cardiovascular disease (ASCVD) in individuals aged 10 to 54 years. While subclinical vascular injury and traditional risk factors are rising, the primary causal drivers of clinical events remain cumulative exposure to ApoB-containing lipoproteins and tobacco use. For clinical practice, the authors advocate for age-appropriate risk assessment, including at least one lipid and lipoprotein(a) screening in adulthood, alongside targeted evaluation for familial hypercholesterolemia and other high-risk profiles. Universal coronary calcium or carotid imaging is not recommended, but digital health tools may help improve patient engagement in prevention strategies.","created":"2026-10-08T00:49:34Z","updated":"2026-10-08T00:49:34Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Deze narratieve review belicht de oorzaken en preventie van vroegtijdige atherosclerotische cardiovasculaire ziekte (ASCVD) bij jongeren tot 54 jaar. Hoewel de prevalentie van risicofactoren zoals obesitas, hypertensie en dyslipidemie stijgt, zijn de causale drivers voor klinische ASCVD voornamelijk cumulatieve blootstelling aan ApoB-lipoproteïnen en roken. Voor de klinische praktijk wordt geadviseerd om te combineren met leeftijdsgerichte risicoscreening, waaronder een eenmalige lipiden- en Lp(a)-bepaling in het volwassen leven, met een gerichte evaluatie bij specifieke risicoprofielen. Universele beeldvorming zoals CAC-scans wordt afgeraden, maar digitale tools kunnen de patiëntbetrokkenheid ondersteunen.","abstract_original":"Early-onset atherosclerotic cardiovascular disease (ASCVD) must be distinguished from cardiovascular risk factors and subclinical vascular abnormalities that may arise at younger ages. This narrative review critically examines lifestyle, environmental, metabolic, psychosocial, and inherited determinants among adolescents (10-19 years), young adults (20-39 years), and selected adults aged 40-54 years who remain within commonly used thresholds for premature events. The 40-54-year band is included selectively to bridge younger-adult prevention with guideline-based adult risk assessment and is not intended to redefine the upper age limit of premature ASCVD. Epidemiological evidence demonstrates a substantial burden of cardiovascular disease (CVD) among people aged 15-39 years; however, evidence of increasing clinically manifest ASCVD is less consistent than evidence of rising obesity, hypertension, dyslipidemia, diabetes, nicotine exposure, and subclinical vascular injury. Established causal drivers, including cumulative exposure to apolipoprotein B-containing lipoproteins and cigarette smoking, are distinguished from predominantly associative evidence concerning sleep disruption, psychosocial stress, e-cigarette use, and air pollution. Prevention should combine population-level health promotion with age-appropriate clinical risk assessment, including lipid screening and measurement of lipoprotein(a) at least once in adulthood, with additional targeted evaluation for familial hypercholesterolemia, a family history of premature ASCVD, obesity, hypertension, diabetes, chronic kidney disease, and smoking or vaping. Coronary artery calcium scoring and carotid imaging are not recommended as universal screening tests for asymptomatic young people, although they may refine clinical decisions in carefully selected adults. Digital tools may support engagement but should complement, rather than replace, validated clinical care and public-health measures."}