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Risk factors and development of atherosclerosis in childhood

Sarah D de Ferranti, MD, MPH
Jane W Newburger, MD, MPH
Section Editor
David R Fulton, MD
Deputy Editor
Carrie Armsby, MD, MPH


Although cardiovascular disease (CVD) is generally manifest in adulthood, the process of atherosclerosis can begin early in childhood [1]. 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 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) [1,2].

The evidence linking atherosclerotic changes in childhood to CVD will be reviewed here. In addition, risk factors in childhood that are associated with early atherosclerosis and CVD will also be discussed (table 1).

Primary pediatric intervention to reduce or minimize atherosclerosis, and identifying and managing the child at risk for atherosclerosis, are discussed separately. (See "Pediatric prevention of adult cardiovascular disease: Promoting a healthy lifestyle and identifying at-risk children" and "Overview of the management of the child at risk for atherosclerosis".)


Overview — Evidence for the development of atherosclerosis in childhood includes autopsy studies showing atherosclerotic changes in the young, and noninvasive, indirect data showing vascular changes associated with adult cardiovascular disease (CVD).

In addition, these studies demonstrate an association between premature atherosclerosis and well-established adult CVD risk factors (eg, overweight/obesity, hypertension, dyslipidemia, and smoke exposure).

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Literature review current through: Nov 2017. | This topic last updated: Oct 13, 2016.
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