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The genesis of atherosclerosis in pediatric age-group
1Department of Pathology, Children's Psychiatric Research Institute, London, Ontario, Canada.
Insights
Atherosclerosis begins in childhood, with early plaque precursors found in infants. Lifestyle interventions during childhood and adolescence are crucial for preventing adult cardiovascular disease.
Area of Science:
- Cardiovascular Science
- Pediatric Medicine
- Public Health
Background:
- Atherosclerotic plaque precursors, including fatty streaks, gelatinous elevations, and microthrombi, are present in the arteries of normal children.
- These early lesions can either regress or progress to advanced stages, leading to significant clinical complications.
- Atherosclerosis is a leading cause of mortality and morbidity in Western societies.
Purpose of the Study:
- To highlight the pediatric origins of atherosclerosis.
- To emphasize the critical window for preventive interventions during childhood and adolescence.
- To underscore the importance of modifying risk factors early in life.
Main Methods:
- Review of existing literature on the early development of atherosclerosis.
- Analysis of risk factors contributing to the progression of atherosclerotic lesions.
- Emphasis on lifestyle modifications and their impact on disease prevention.
Main Results:
- Atherosclerotic precursors are a common finding in children's arteries.
- Progression of these lesions is linked to various lifestyle and health factors.
- Early intervention is key to preventing advanced disease.
Conclusions:
- Atherosclerosis is fundamentally a pediatric problem due to its origins in early life.
- Preventive strategies targeting lifestyle factors in children and adolescents are essential.
- Modifying diet, managing hypertension and diabetes, avoiding smoking, and promoting physical activity can mitigate atherosclerosis risk.
Abstract:
The three forms of origin of the atherosclerotic plaque of adults, that is, the fatty streaks, gelatinous elevations, and microthrombi, all occur in arteries of normal infants and children. Some of these may become arrested or regress, but many progress to the prominent lesions that precipitate various clinical catastrophies. The aim of modern medicine is to modify or eliminate many of the factors known to advance the atherosclerotic process and thus decrease the incidence of this disease, which ranks highest on the list of causes of morbidity and mortality in the Western world. Of these factors, some may be controlled by dietary means (low salt; low total fat and cholesterol; appropriate ratios of saturated to mono- and polyunsaturated fatty acids; high content of complex carbohydrates and fiber); controlling hypertension, diabetes, and obesity; abstaining from cigarette smoking; and vigorous physical activities. Because patterns of life-style are determined in childhood and adolescence, and because it is only during that period of life that measures to prevent progression of atherosclerosis may be predictably effective, it becomes increasingly apparent that atherosclerosis is, indeed, a pediatric problem.