Pediatric prevention of adult cardiovascular disease: Promoting a healthy lifestyle and identifying at-risk children
- Sarah D de Ferranti, MD, MPH
Sarah D de Ferranti, MD, MPH
- Director, Preventive Cardiology Clinic
- Department of Cardiology
- Boston Children's Hospital
- Jane W Newburger, MD, MPH
Jane W Newburger, MD, MPH
- Commonwealth Professor of Pediatrics
- Harvard Medical School
Although cardiovascular disease (CVD) is generally manifest in adulthood, the process of atherosclerosis can begin early in childhood . For most children, atherosclerotic vascular changes are minor and can be minimized or even prevented with adherence to a healthy lifestyle. However, in some children, the atherosclerotic process is accelerated because of the presence of identifiable risk factors (eg, obesity and hypertension) and/or specific diseases that are associated with premature CVD (eg, diabetes mellitus and Kawasaki disease [KD]) (table 1) [1,2].
Primary prevention measures to minimize the risk of developing atherosclerosis in childhood will be reviewed here. In addition, the primary care assessment to identify the child at risk for premature atherosclerosis, and, by extension, CVD, will also be discussed. Risk factors for early atherosclerosis in childhood and the management of the child at risk for atherosclerosis are reviewed separately. (See "Risk factors and development of atherosclerosis in childhood" and "Overview of the management of the child at risk for atherosclerosis".)
CARDIOVASCULAR HEALTH PROMOTION
The two primary goals of cardiovascular health promotion in children are [1,3]:
●Prevention of the development of risk factors associated with atherosclerosis (primordial prevention) based on general measures that focus on adherence to a healthy lifestyle.
●Identification and management of the child at risk for early atherosclerosis based on the presence of established risk factors including hypertension, obesity, dyslipidemia, insulin resistance, physical inactivity, and smoke exposure. (See "Risk factors and development of atherosclerosis in childhood", section on 'Risk factors'.)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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