You’ll probably never meet a kid with atherosclerosis. But you probably know more than a few who carry the seeds. Risk factors and risk behaviors that grow cardiovascular disease begin in childhood. That’s why the National Heart, Lung, and Blood Institute (NHLBI), recently convened an expert panel and published new Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. The guidelines address the following:
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- Preventing development of risk factors at a young age
- Spotting children with risk factors present
- Tackling risk factors at a young age
The new guidelines include screenings starting with reviewing family history and teaching family healthy behaviors from birth. The focus is on tobacco exposure, diet, overweight and obesity issues, blood pressure and physical activity.
Screening and assessment should continue throughout childhood and includes the recommendation that children have their blood cholesterol levels checked between ages 9 and 11, and again between 17 and 21. And that’s not just a few kids. That is all children. In addition, it is suggested that children who are overweight with other risk factors (such as a family history of heart disease) be tested for diabetes at age 10 or a few years later.
In 2001, Cleveland Clinic cardiologist E. Murat Tuzcu, MD, led a study that involved 260 heart transplant patients; the age of the donors in these transplantation cases ranged in age from 13 to 55 years. These observations allowed them to measure the prevalence of atherosclerotic plaques in their coronary arteries. Using intravascular ultrasound imaging, they discovered that in some patients coronary atherosclerosis begins at a young age, that lesions are present in one of every six asymptomatic teenagers and this prevalence increases as one ages.
“Heart disease starts in our children,” says Stanley Hazen, MD, PhD, head of Preventive Cardiology at Cleveland Clinic. “Prevention should, and needs to, start with our children. I enthusiastically endorse the recommendations for wider screening and prevention efforts.”
[The guidelines include a great table that outlines the cardiovascular screening schedule from birth to 21 years.]