Cardiovascular disease burden in children with obesity: A narrative review

Area of Science:

• Pediatric Cardiology
• Public Health
• Vascular Biology

Background:

• Childhood obesity is a growing epidemic with early onset of cardiovascular disease (CVD).
• Subclinical atherosclerosis, a precursor to CVD, begins in childhood and is potentially reversible.
• Current CVD risk stratification guidelines for obese children lack diagnostic tests for early vascular changes.

Purpose of the Study:

• To review the diagnosis and management of obesity-related CVD complications in children.
• To highlight the need for incorporating subclinical atherosclerosis detection into clinical practice.
• To identify potential diagnostic tools for early CVD detection in pediatric obesity.

Main Methods:

• Comprehensive literature search (2010-2025) in PubMed and Cochrane Database.
• Keywords included obesity, children, cardiovascular, subclinical atherosclerosis, vascular health, and cardiometabolic risk.
• Data synthesis on diagnosis, management, and diagnostic tools for pediatric obesity and CVD.

Main Results:

• Atherosclerosis has detectable, reversible stages in childhood, often missed by current guidelines.
• Tools like carotid intima-media thickness and pulse wave velocity show links to obesity and cardiometabolic risk.
• Lack of consensus hinders the routine use of these vascular health assessment tools in clinical care.

Conclusions:

• Early detection of subclinical atherosclerosis in obese children is crucial for CVD prevention.
• Existing guidelines need enhancement to include diagnostic methods for early vascular changes.
• Further research is required to establish validated tools for routine clinical use in diagnosing subclinical CVD in pediatric obesity.