Childhood origins of arterial disease
Marietta Charakida1, John E Deanfield, Julian P J Halcox
1Cardiac Unit, Institute of Child Health, University College London, 30 Guilford Street, London, UK.
Insights
Childhood risk factors significantly impact adult arterial disease. Early detection and prevention of atherosclerosis in children offer the best chance for intervention, as the disease is most reversible at this stage.
Area of Science:
- Cardiovascular Research
- Pediatric Cardiology
- Vascular Biology
Background:
- Atherosclerosis originates in early life, with childhood risk factors tracking into adulthood.
- Conventional and novel cardiovascular risk factors contribute to the development of arterial disease.
- Early identification of preclinical atherosclerotic changes is crucial for effective intervention.
Purpose of the Study:
- To review the significance of childhood risk factors in the development of adult arterial disease.
- To discuss the role of noninvasive techniques in characterizing preclinical atherosclerosis.
- To highlight the potential of primary prevention strategies initiated in childhood.
Main Methods:
- Review of existing literature on childhood risk factors and arterial disease.
- Discussion of noninvasive functional and structural imaging techniques.
- Exploration of research on vascular repair mechanisms and endothelial progenitor cells.
Main Results:
- Noninvasive techniques allow characterization of early arterial disease before complications arise.
- Childhood cardiovascular risk factors demonstrably impact preclinical atherosclerotic changes.
- Research is expanding to include vascular repair mechanisms and endothelial progenitor cells.
Conclusions:
- Atherosclerosis has its origins in early life, making childhood a critical window for prevention.
- Primary prevention strategies for adult cardiovascular disease, starting in childhood, hold significant potential.
- Guidelines for early-life screening and therapeutic interventions are increasingly available.
Purpose Of Review:
The present article reviews the importance of classical and novel risk factors that present in childhood, track into adult life and contribute to arterial disease. The value of noninvasive techniques that can assist in characterization of preclinical atherosclerotic changes as intermediate phenotypes is also discussed.
Recent Findings:
Noninvasive functional and structural techniques are now available and provide the opportunity to characterize early arterial disease long before cardiovascular complications present. By using these techniques, it has been possible to quantify the impact of conventional and novel cardiovascular risk factors seen in childhood on the development of preclinical atherosclerotic changes. Scientific interest has recently widened to include not only study of mechanisms and biomarkers of injury but also mechanisms that promote vascular repair. In this new field, characterization of endothelial progenitor cells has presented new opportunities for cardiovascular research.
Summary:
Atherosclerosis begins in early life. Primary prevention strategies for adult cardiovascular disease beginning in childhood have great potential as the disease process is most reversible at this stage. Several guidelines have recently been published for screening and implementation of appropriate therapeutic choices in early life.
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