Cholesterol (and cardiovascular risk) in adolescence

Atherosclerosis is a significant cause of adult morbidity and mortality. New evidence confirms that it begins in childhood and accelerates at adolescence. Many new studies have solidified the understanding of its risk factors and changed the approach to their clinical management.

The important descriptions of known risk factors and their clear relation to the pathophysiologic process of atherosclerosis are reviewed here. Some emerging risk factors are discussed. Furthermore, the many new studies on treatment options are reviewed.

These new findings make it imperative that adolescents be screened for traditional risk factors and that they be treated with therapeutic lifestyle change. With the weight of new evidence on the safety and efficacy of statins in this age group, clinicians can feel more confident in their use when indicated. Research into emerging risk factors like obesity, metabolic syndrome, diabetes. and homocysteine will be important in the future management.