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Cardiovascular risk factors in children. Should they concern the pediatrician?
Insights
Cardiovascular risk factors like obesity and high blood pressure (BP) can emerge in childhood, potentially leading to early atherosclerosis and heart disease. Early lifestyle interventions are crucial for prevention.
Area of Science:
- Cardiovascular Medicine
- Pediatric Cardiology
- Public Health
Background:
- Atherosclerosis, coronary artery disease, and essential hypertension have origins in early life.
- The Bogalusa Heart Study investigated pediatric cardiovascular risk factors within a community setting.
Purpose of the Study:
- To examine cardiovascular risk factors and their determinants in children.
- To identify the tracking of risk factors over time and the clustering of multiple risk factors.
- To explore interrelationships between risk factors and their potential to promote premature atherosclerosis.
Main Methods:
- Longitudinal community-based study design.
- Collection of reliable measurements for serum lipoproteins, obesity, blood pressure (BP), and plasma insulin levels.
- Analysis of data to assess risk factor tracking and clustering.
Main Results:
- Correlations found between serum lipoprotein levels, obesity, BP, and plasma insulin levels post-glucose load, suggesting causal links.
- Evidence of risk factor tracking and aggregation during the pediatric age span.
- Behavioral factors like smoking and Type A behavior may contribute to early disease.
Conclusions:
- Cardiovascular risk factors and their interrelationships are established in childhood.
- These early factors can enhance the development of premature atherosclerosis and coronary artery disease.
- Physicians should assess pediatric risk factors and promote lifestyle changes to prevent adult cardiovascular diseases.
Abstract:
There is evidence that atherosclerosis, coronary artery disease, and essential hypertension begin early in life. The Bogalusa (La) Heart Study has examined cardiovascular risk factors and their determinants during the pediatric age span in a total community study. Reliable measurements were obtained and then analyzed to identify "tracking" of risk factors over time and clusters or aggregations of various risk factors at high levels. Serum lipoprotein levels, obesity, BP, and plasma insulin levels were all correlated after a glucose load, implying causal interrelationships. Although such relationship are only partly elucidated, the associations potentially enhance premature atherosclerosis. Certain kinds of behavior, for example cigarette smoking and type A behavior, may also contribute to early coronary artery disease. Our observations suggest that practicing physicians should assess risk factors in children and encourage changes in life-style to combat the high incidence of coronary artery disease and essential hypertension in the United States.