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Primary prevention of cardiovascular disease in childhood: recent knowledge and unanswered questions
1Department of Pediatrics, Memorial University of Newfoundland, St. John's, Canada.
Insights
Early identification of children at risk for cardiovascular disease (CVD) is crucial. Screening children aged 4-7 and intervening with lifestyle changes or medication can reduce future CVD risk factors.
Area of Science:
- Pediatrics
- Cardiovascular Health
- Preventive Medicine
Background:
- Chronic diseases in adulthood often have origins in early life.
- Identifying children at risk for cardiovascular disease (CVD) is essential for prevention.
- Selective screening of children is currently more practical than universal screening.
Purpose of the Study:
- To outline strategies for identifying and managing cardiovascular disease risk factors in children.
- To emphasize the importance of early life interventions for long-term cardiovascular health.
Main Methods:
- Recommends screening children aged 4-7 for CVD risk factors.
- Suggests a complete lipid-lipoprotein profile for total cholesterol > 200 mg/dl.
- Advocates for dietary advice, exercise, and potentially medication for abnormal lipid levels.
Main Results:
- An integrated approach involving lifestyle changes and medical intervention can reduce cardiovascular risk factors.
- Perinatal nutrition and addressing low birth weight may also impact adult CVD risk.
Conclusions:
- Early detection and management of CVD risk factors in children are vital for adult cardiovascular health.
- Interventions in early life, including nutrition and lifestyle, can mitigate long-term cardiovascular disease risks.
Abstract:
Efforts at prevention of chronic disease in adult life must include investigation of causal pathogenetic clues in early life. There is adequate rationale for identification of children who are at risk of developing cardiovascular disease (CVD) in later years. At the present time, practical considerations would favor a selective rather than universal screening of children. If the latter is instituted, then it is ideal to test children 4-7 years of age. In either case, total cholesterol greater than 200 mg/dl warrants a complete lipid-lipoprotein profile. Those with confirmed abnormal values of total cholesterol, low-density lipoprotein cholesterol, and apolipoproteins A1 and B should be offered dietary advice and encouraged to participate in regular exercise. In a few cases, drug therapy would be required. Limited data suggest that an integrated approach will result in a reduction of cardiovascular risk factors. Perinatal nutrition also may influence the risk of CVD among adults; a reduction in the prevalence of low birth weight and prevention of failure to thrive in early infancy may be additional useful strategies for prevention of CVD.