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Cardiovascular disease risk factors and atherosclerosis in children and adolescents

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Abstract

As more is learned about the natural history of the development of atherosclerosis, it is clear that the process that results in morbidity and mortality in adults has its origins in childhood and adolescence. It is also clear that the traditional risk factors, such as hypertension and dyslipidemia, are important in the early stages of the process. It appears that the prevalence and severity of obesity are increasing in children and adolescents in the United States. This trend is associated with increasing blood pressure and the occurrence of type 2 diabetes mellitus in young individuals. These trends may result in increased cardiovascular morbidity and mortality as these overweight pediatric patients become obese adults. Intervention and prevention strategies should be directed at the pediatric population as a whole, as well as at higher-risk individuals. For the latter, it will be necessary to identify those at highest risk. Both nonpharmacologic and pharmacologic approaches may be necessary for treatment of pediatric patients with hyperlipidemia and hypertension. Studies are needed that evaluate the longer-term impact of intervention on cardiovascular risk factors in young patients.

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References and Recommended Reading

  1. Klotz O, Manning MF: Fatty streaks in the intima of arteries. J Pathol Bacteriol 1911, 16:211.

    Article  Google Scholar 

  2. Aschoff L: Atherosclerosis in Lectures on Pathology. New York: Hoeber; 1924:131–153.

    Google Scholar 

  3. Enos WF, Holmes RH, Beyer J: Coronary disease among United States soldiers killed in action in Korea: preliminary report. JAMA 1953, 152:1090–1093.

    CAS  Google Scholar 

  4. McNamara JJ, Molot MA, Stremple JF, Cutting RT: Coronary artery disease in combat casualties in Vietnam. JAMA 1971, 7:1185–1187.

    Article  Google Scholar 

  5. Tuzcu EM, Kapadia SR, Tutar E, et al.: High prevalence of coronary atherosclerosis in asymptomatic teenagers and young adults. Circulation 2001, 103:2705–2710.

    PubMed  CAS  Google Scholar 

  6. PDAY Research Group: Relationship of atherosclerosis in young men to serum lipoprotein cholesterol concentrations and smoking: a preliminary report from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. JAMA 1990, 264:3018–3024.

    Article  Google Scholar 

  7. McGill HC, McMahan CA, Zieske AW, et al., for the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group: Effects of nonlipid risk factors on atherosclerosis in youth with a favorable lipoprotein profile. Circulation 2001, 103:1546–1550.

    PubMed  CAS  Google Scholar 

  8. Newman WP III, Freedman DS, Voors AW, et al.: Relation of serum lipoprotein levels and systolic blood pressure to early atherosclerosis. N Engl J Med 1986, 314:138–144.

    Article  PubMed  Google Scholar 

  9. Berenson GS, Srinivasan SR, Bao W, et al., for the Bogalusa Heart Study: Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med 1998, 338:1650–1656.

    Article  PubMed  CAS  Google Scholar 

  10. Mahoney LT, Burns TL, Stanford W, et al.: Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. J Am Coll Cardiol 1996, 27:277–284.

    Article  PubMed  CAS  Google Scholar 

  11. Eckel RH, Krauss RM: American Heart Association call to action: Obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee. Circulation 1998, 21:2099–2100.

    Google Scholar 

  12. Luepker RV, Jacobs DR, Prineas RJ, Sinaiko AR: Secular trends of blood pressure and body size in a multi-ethnic adolescent population: 1986 to 1996. J Pediatr 1999, 134:668–674.

    Article  PubMed  CAS  Google Scholar 

  13. Morrison JA, James FW, Sprecher DL, et al.: Sex and race differences in secular trends in cardiovascular disease risk factors in school children: The Princeton School Study 1975–1990. Am J Pub Health 1999, 89:1708–1714.

    PubMed  CAS  Google Scholar 

  14. Ogden CL, Troiano RP, Briefel RR, et al.: Prevalence of overweight among preschool children in the United States 1971 through 1994. Pediatrics 1997, 99:E1.

    Google Scholar 

  15. Troiano RP, Flegal KM, Kuczmarski RJ, et al.: Overweight prevalence and trends for children and adolescents. The National Health and Nutrition Examination Surveys, 1963 to 1991. Arch Pediatr Adolesc Med 1995, 149:1085–1091.

    PubMed  CAS  Google Scholar 

  16. Fagot-Campagna A, Pettitt DJ, Engelgau MM, et al.: Type 2 diabetes among North American children and adolescents: An epidemiologic review and a public health perspective. J Pediatr 2000, 136:664–672.

    Article  PubMed  CAS  Google Scholar 

  17. Pinhas-Hamiel O, Dolan LM, Daniels SR, et al.: Increased incidence of non-insulin-dependent diabetes mellitus among adolescents. J Pediatr 1996, 128:608–615.

    Article  PubMed  CAS  Google Scholar 

  18. Adelman RD, Restaino IG, Alon US, Blowey DL: Proteinuria and focal segmental glomerulosclerosis in severely obese adolescents. J Pediatr 2001, 138:481–485.

    Article  PubMed  CAS  Google Scholar 

  19. Welch TR, Daniels SR: Yet another target organ of obesity. J Pediatr 2001, 138:455–456.

    Article  PubMed  CAS  Google Scholar 

  20. Boushey CJ, Beresford SA, Omenn GS, Motulsky AG: A quantitative assessment of plasma homocysteine as a risk factor for vascular disease: probable benefits of increasing folic acid intakes. JAMA 1995, 274:1049–1057.

    Article  PubMed  CAS  Google Scholar 

  21. Morrison JA, Jacobsen DW, Sportier DL, et al.: Serum glutathione in adolescent males predicts parental coronary heart disease. Circulation 1999, 100:2244–2247.

    PubMed  CAS  Google Scholar 

  22. Ridker PM, Cushman M, Stampfer MJ, et al.: Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997, 336:973–979.

    Article  PubMed  CAS  Google Scholar 

  23. Visser M, Bouter LM, McQuillan GM, et al.: Elevated C-reactive protein levels in overweight and obese adults. JAMA 1999, 282:2131–2135.

    Article  PubMed  CAS  Google Scholar 

  24. Ford ES, Galuska DA, Gillespie C, et al.: C-reactive protein and body mass index in children: Findings from the Third National Health and Nutrition Examination Survey, 1988–1994. J Pediatr 2001, 138:486–492.

    Article  PubMed  CAS  Google Scholar 

  25. Levy D, Garrison RJ, Savage DD, et al.: Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 1990, 322:1561–1566.

    Article  PubMed  CAS  Google Scholar 

  26. deSimone G, Devereux RB, Daniels SR, et al.: Effect of growth on variability of left ventricular mass: assessment of allometric signals in adults and children and their capacity to predict cardiovascular risk. J Am Coll Cardiol 1995, 25:1056–1062.

    Article  CAS  Google Scholar 

  27. Daniels SR, Loggie JM, Khoury P, Kimball TR: Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. Circulation 1998, 97:1907–1911.

    PubMed  CAS  Google Scholar 

  28. Ganau A, Devereux RB, Roman MJ, et al.: Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. J Am Coll Cardiol 1992, 19:1550–1558.

    Article  PubMed  CAS  Google Scholar 

  29. Whitaker RC, Wright JA, Pepe MS, et al.: Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997, 337:869–873.

    Article  PubMed  CAS  Google Scholar 

  30. Steinberger J, Moran A, Hong CP, et al.: Adiposity in childhood predicts obesity and insulin resistance in young adulthood. J Pediatr 2001, 138:469–473.

    Article  PubMed  CAS  Google Scholar 

  31. Morrison JA, Barton BA, Biro FM, et al.: Overweight, fat patterning and cardiovascular disease risk factors in black and white boys. J Pediatr 1999, 135:451–457.

    Article  PubMed  CAS  Google Scholar 

  32. Morrison JA, Sprecher DL, Barton BA, et al.: Overweight, fat patterning and cardiovascular disease risk factors in black and white girls: The National Heart, Lung and Blood Institute Growth and Health Study. J Pediatr 1999, 135:458–464.

    Article  PubMed  CAS  Google Scholar 

  33. Lauer RM, Lee J, Clarke WR: Factors affecting the relationship between childhood and adult cholesterol levels: The Muscatine Study. Pediatrics 1988, 82:308–318.

    Google Scholar 

  34. Lauer RM, Clarke WR: Childhood risk factors for high adult blood pressure: The Muscatine Study. Pediatrics 1989, 84:633–641.

    PubMed  CAS  Google Scholar 

  35. Barker DJ, Gluckman PD, Godfrey KM, et al.: Fetal nutrition and cardiovascular disease in adult life. Lancet 1993, 341:938–941.

    Article  PubMed  CAS  Google Scholar 

  36. Osmond C, Barker DJ, Winter PD, et al.: Early growth and death from cardiovascular disease in women. BMJ 1993, 307:1519–1524.

    PubMed  CAS  Google Scholar 

  37. Hales CN, Barker DJ, Clark PM, et al.: Fetal and infant growth and impaired glucose tolerance at age 64. BMJ 1991, 303:1019–1022.

    PubMed  CAS  Google Scholar 

  38. Barker DJ, Osmond C, Golding J, et al.: Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease. BMJ 1989, 298:564–567.

    Article  PubMed  CAS  Google Scholar 

  39. Donker GA, Labarthe DR, Harrist RB, et al.: Low birth weight and blood pressure at age 7–11 years in a biracial sample. Am J Epidemiol 1997, 145:387–397.

    PubMed  CAS  Google Scholar 

  40. Hinchcliffe S: The effect of intrauterine growth retardation on the development of renal nephrons. Br J Ob Gyn 1992, 99:296–304.

    Google Scholar 

  41. Desai M, Hales C: Role of fetal and infant growth in programming metabolism in later life. Biol Rev 1997, 72:329–348.

    Article  PubMed  CAS  Google Scholar 

  42. Barlow SE, Dietz WH: Obesity evaluation and treatment: Expert Committee recommendations: The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics 1998, 102:E29.

    Google Scholar 

  43. American Academy of Pediatrics. National Cholesterol Education Program: Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics 1992, 89(3 Pt 2):525–584.

    Google Scholar 

  44. Obarzanek E, Kimm SY, Barton BA, et al., for the DISC Collaborative Research Group: Long-term safety and efficacy of a cholesterol-lowering diet in children with elevated low-density lipoprotein cholesterol: seven year results of the Dietary Intervention Study in Children (DISC). Pediatrics 2001, 107:256–264.

    Article  PubMed  CAS  Google Scholar 

  45. Sprecher DL, Daniels SR: Rational approach to pharmacologic reduction of cholesterol levels in children. J Pediatr 1996, 129:4–7.

    Article  PubMed  CAS  Google Scholar 

  46. Report of the Second Task Force on Blood Pressure Control in Children-1987.Pediatrics 1987, 79:1–25.

  47. Roccella EJ, Anderson DE: Update on the Task Force Report (1987) on High Blood Pressure in Children and Adolescents: A Working Group Report from the High Blood Pressure Education Program. Pediatrics 1996, 98:649–658.

    Google Scholar 

  48. Jones DW, Frohlich ED, Grim CM, et al.: Mercury sphygmomanometers should not be abandoned: an advisory statement from the Council for High Blood Pressure Research, American Heart Association. Hypertension 2001, 37:185–186.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Cardiology, Children’s Hospital Medical Center, 3333 Burnet Avenue, 45229, Cincinnati, OH, USA

    Stephen R. Daniels MD, PhD

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  1. Stephen R. Daniels MD, PhD
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Daniels, S.R. Cardiovascular disease risk factors and atherosclerosis in children and adolescents. Curr Atheroscler Rep 3, 479–485 (2001). https://doi.org/10.1007/s11883-001-0038-3

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  • DOI: https://doi.org/10.1007/s11883-001-0038-3

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