A prospective study suggests that incident cardiovascular disease (CVD) event risk depends on the time course of cumulative prior exposure to low-density lipoprotein cholesterol (LDL-C), the younger the age of exposure accumulation, the greater risk increase. The study included 4,958 asymptomatic adults age 18 to 30 years enrolled from 1985 to 1986. During a median 16-year follow-up after age 40 years, 275 participants had an incident CVD event (a composite of nonfatal coronary heart disease, stroke, transient ischemic attack, heart failure hospitalization, cardiac revascularization, peripheral arterial disease intervention, or cardiovascular death). After adjustment for sex, race, and traditional risk factors, both area under LDL-C versus age curve and time course of area accumulation (slope of LDL-C curve) were significantly associated with CVD event risk (hazard ratio: 1.053; per 100 mg/dl × years; hazard ratio: 0.797 per mg/dl/year; respectively). The findings suggest the importance of optimal LDL-C control starting early in life. Source: https://www.onlinejacc.org/