Beginning With the End in Mind: The Case for Primordial and Primary Cardiovascular Prevention in Youth

Cardiovascular disease remains the leading cause of death worldwide. Although there is little direct evidence that ties the presence of risk factors in childhood with adult cardiovascular disease, there are multiple indirect lines of evidence that, when synthesized, make a strong case for maintaining cardiovascular health through childhood and adolescence as well as screening for and treating risk factors when they develop to diminish lifetime risk. This review summarizes these lines of evidence and asserts that it is imperative that primordial and primary cardiovascular risk reduction begins early.