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Increased understanding of the process that leads to atherosclerotic cardiovascular disease has prompted changes to clinical practice for preventive cardiologists who care for young adults. More and more, cardiologists are taking a proactive stance on managing long-term risk in patients under 40. They are using advanced assessment tools to identify subclinical disease in those patients with nonmodifiable risk factors and are targeting modifiable risk factors in patients at an earlier age.

Granted, it is not always easy to convince a patient not yet middle-aged that he or she needs to commit to significant long-term lifestyle changes that can reduce risk over the course of decades. Barriers to success abound in a culture that promotes processed foods and fosters sedentary habits. Still, the latest ACC/AHA guidelines recommend assessment of lifetime risk in patients as young as 20, expanding primary prevention care to millennials, who may believe that heart disease is a concern reserved for older generations.

Physicians from Emory University School of Medicine weigh in on the importance of early risk assessment and proactive risk management in young adults. Indeed, cardiologists advocate for increased awareness among parents and pediatricians of the growing body of evidence that heart disease is present long before it attacks, and they assert that early vigilance is the best defense.

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