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Cardiovascular Disease Risk Factors: A Childhood Perspective

  • Symposium on Chronic NonCommunicable Diseases and Children
  • Published:
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Abstract

Atherosclerotic cardiovascular disease (CVD) is one of the leading causes of death and disability worldwide including in developing countries like India. Indians are known to be predisposed to CVD, which occur almost a decade earlier in them. Though these diseases manifest in the middle age and beyond, it is now clear that the roots of CVD lie in childhood and adolescence. Many of the conventional risk factors of CVD such as high blood pressure, dyslipidemia, tobacco use, unhealthy diet and obesity have their beginnings in childhood and then track overtime. It is thus important to screen and identify these risk factors early and treat them to prevent onset of CVD. Similarly community based strategies to prevent onset of these risk factors is imperative to tackle this burgeoning public health crisis especially in countries like ours with limited resources.

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References

  1. WHO. The global burden of disease report; 2004 update.

  2. W.H.O and US Centers for Disease Control and Prevention (CDC). The Atlas of Heart Disease and Stroke. 2011.

  3. Joshi P, Islam S, Pais P, et al. Risk factors for early myocardial infarction in South Asians compared with individuals in other countries. JAMA. 2007;297:286–94.

    Article  PubMed  CAS  Google Scholar 

  4. Patel V, Chatterji S, Chisholm D, et al. Chronic diseases and injuries in India. Lancet. 2011;377:413–28.

    Article  PubMed  Google Scholar 

  5. Newman WP 3rd, Freedman DS, Voors AW, et al. Relation of serum lipoprotein levels and systolic blood pressure to early atherosclerosis. The Bogalusa Heart Study. N Engl J Med. 1986;314:138–44.

    Article  PubMed  Google Scholar 

  6. Berenson GS, Srinivasan SR, Bao W, Newman WP, Tracy RE, Wattigney WA, for the Bogalusa Heart Study. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med. 1998;338:1650–6.

    Article  PubMed  CAS  Google Scholar 

  7. McGill HC Jr, McMahan CA. Determinants of atherosclerosis in the young. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) research group. Am J Cardiol. 1998;82:30T–6T.

    Article  PubMed  Google Scholar 

  8. Gupta R, Goyle A, Kashyap S, Agarwal M, Consul R, Jain BK. Prevalence of atherosclerosis risk factors in adolescent school children. Indian Heart J. 1998;50:511–5.

    PubMed  CAS  Google Scholar 

  9. Davis PH, Dawson JD, Riley WA, Lauer RM. Carotid intimal-medial thickness is related to cardiovascular risk factors measured from childhood through middle age: the Muscatine Study. Circulation. 2001;104:2815–9.

    Article  PubMed  CAS  Google Scholar 

  10. Juonala M, Magnussen CG, Venn A, et al. Influence of age on associations between childhood risk factors and carotid intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study, the Childhood Determinants of Adult Health Study, the Bogalusa Heart Study, and the Muscatine Study for the International Childhood Cardiovascular Cohort (i3C) consortium. Circulation. 2010;122:2514–20.

    Article  PubMed  Google Scholar 

  11. Raitakari OT, Juonala M, Kähönen M, et al. Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA. 2003;290:2277–83.

    Article  PubMed  CAS  Google Scholar 

  12. Urbina EM, Kieltkya L, Tsai J, Srinivasan SR, Berenson GS. Impact of multiple cardiovascular risk factors on brachial artery distensibility in young adults: the Bogalusa Heart Study. Am J Hypertens. 2005;18:767–71.

    Article  PubMed  Google Scholar 

  13. Barker DJP. Fetal origins of coronary heart disease. BMJ. 1995;311:171.

    Article  PubMed  CAS  Google Scholar 

  14. Yusuf S, Cairns J, Camm J, Fallen E, Geersh B. Evidence-based cardiology. 3rd ed. West Sussex: Wiley Blackwell; 2009.

    Google Scholar 

  15. Lakshmy R, Fall CH, Sachdev HS, et al. Childhood body mass index and adult pro-inflammatory and pro-thrombotic risk factors: data from the New Delhi birth cohort. Int J Epidemiol. 2011;40:102–11.

    Article  PubMed  Google Scholar 

  16. Fall CH, Sachdev HS, Osmond C, et al; New Delhi Birth Cohort. Adult metabolic syndrome and impaired glucose tolerance are associated with different patterns of BMI gain during infancy. Diabetes Care. 2008;31:2349–56.

    Article  PubMed  Google Scholar 

  17. Intenational Obesity Task Force Report 2010.

  18. Sharma A, Sharma K, Mathur KP. Growth pattern and prevalence of obesity in affluent schoolchildren of Delhi. Public Health Nutr. 2007;10:485–91.

    PubMed  CAS  Google Scholar 

  19. Reilly JJ, Dorosty AR. Epidemic of obesity in UK children. Lancet. 1999;354:1874–5.

    Article  PubMed  CAS  Google Scholar 

  20. Troiano RP, Flegal KM, Kuczmarski RJ, Campbell SM, Johnson CL. Overweight prevalence and trends for children and adolescents. The National Health and Nutrition Examination Surveys, 1963 to 1991. Arch Pediatr Adolesc Med. 1995;149:1085–91.

    Article  PubMed  CAS  Google Scholar 

  21. Freedman DS, Dietz WH, Srinivasan SR, Berenson GS. The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics. 1999;103:1175–82.

    Article  PubMed  CAS  Google Scholar 

  22. Iannuzzi A, Licenziati MR, Acampora C, et al. Increased carotid intima-media thickness and stiffness in obese children. Diabetes Care. 2004;27:2506–8.

    Article  PubMed  Google Scholar 

  23. Tounian P, Aggoun Y, Dubern B, et al. Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet. 2001;358:1400–4.

    Article  PubMed  CAS  Google Scholar 

  24. Andersen LB. Blood pressure, physical fitness and physical activity in 17-year-old Danish adolescents. J Intern Med. 1994;236:323–9.

    Article  PubMed  CAS  Google Scholar 

  25. Mikkilä V, Räsänen L, Laaksonen MM, et al. Long-term dietary patterns and carotid artery intima media thickness: the Cardiovascular Risk in Young Finns Study. Br J Nutr. 2009;102:1507–12.

    Article  PubMed  Google Scholar 

  26. Van Horn L, Obarzanek E, Barton BA, et al. A summary of results of the Dietary Intervention Study in Children (DISC): lessons learned. Prog Cardiovasc Nurs. 2003;18:28–41.

    Article  PubMed  Google Scholar 

  27. Britten P, Marcoe K, Yamini S, Davis C. Development of food intake patterns for the MyPyramid Food Guidance System. J Nutr Educ Behav. 2006;38:S78–92.

    Article  PubMed  Google Scholar 

  28. Jeemon P, Prabhakaran D, Mohan V, et al; SSIP Investigators. Double burden of underweight and overweight among children (10–19 y of age) of employees working in Indian industrial units. Natl Med J India. 2009;22:172–6.

    PubMed  CAS  Google Scholar 

  29. Pratt CA, Stevens J, Daniels S. Childhood obesity prevention and treatment: recommendations for future research. Am J Prev Med. 2008;35:249–52.

    Article  PubMed  Google Scholar 

  30. Díaz RG, Esparza-Romero J, Moya-Camarena SY, Robles-Sardín AE, Valencia ME. Lifestyle intervention in primary care settings improves obesity parameters among Mexican youth. J Am Diet Assoc. 2010;110:285–90.

    Article  PubMed  Google Scholar 

  31. A Report of the Expert Group of the Indian Council of Medical Research. Nutrient requirements and recommended dietary allowances for Indians. ICMR, ed: New Delhi; 2010.

  32. Strong WB, Malina RM, Blimkie CJ, et al. Evidence based physical activity for school-age youth. J Pediatr. 2005;146:732–7.

    Article  PubMed  Google Scholar 

  33. Andersen LB, Riddoch C, Kriemler S, Hills AP. Physical activity and cardiovascular risk factors in children. Br J Sports Med. 2011;45:871–6.

    Article  PubMed  Google Scholar 

  34. Nielsen GA, Andersen LB. The association between high blood pressure, physical fitness, and body mass index in adolescents. Prev Med. 2003;36:229–34.

    Article  PubMed  Google Scholar 

  35. Ewart CK, Young DR, Hagberg JM. Effects of school-based aerobic exercise on blood pressure in adolescent girls at risk for hypertension. Am J Public Health. 1998;88:949–51.

    Article  PubMed  CAS  Google Scholar 

  36. Hansen HS, Froberg K, Hyldebrandt N, Nielsen JR. A controlled study of 8 mo of physical training and reduction of blood pressure in children: the Odense schoolchild study. BMJ. 1991;303:682–5.

    Article  PubMed  CAS  Google Scholar 

  37. Hagberg JM, Ehsani AA, Goldring D, Hernandez A, Sinacore DR, Holloszy JO. Effect of weight training on blood pressure and hemodynamics in hypertensive adolescents. J Pediatr. 1984;104:147–51.

    Article  PubMed  CAS  Google Scholar 

  38. Raitakari OT, Taimela S, Porkka KV, et al. Associations between physical activity and risk factors for coronary heart disease: the Cardiovascular Risk in Young Finns Study. Med Sci Sports Exerc. 1997;29:1055–61.

    Article  PubMed  CAS  Google Scholar 

  39. Dobbins M, De Corby K, Robeson P, Husson H, Tirilis D. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6–18. Cochrane Database Syst Rev. 2009;1:CD007651.

    PubMed  Google Scholar 

  40. Dhingra V, Chatterjee A, Guleria R, et al. Adverse physical activity patterns in urban adoloscents. J Assoc Physicians India. 2003;50:1521.

    Google Scholar 

  41. Sturm R. Childhood obesity–what we can learn from existing data on societal trends, part 1. Prev Chron Dis. 2005;2:A12.

    Google Scholar 

  42. Dempsey T, Miller A, Boyattia T. Let’s get physical: a policy on increasing physical activity in school-aged children. J Okla State Med Assoc. 2004;97:119–21. quiz 122–3.

    PubMed  Google Scholar 

  43. Telama R, Yang X, Viikari J, Välimäki I, Wanne O, Raitakari O. Physical activity from childhood to adulthood: a 21-year tracking study. Am J Prev Med. 2005;28:267–73.

    Article  PubMed  Google Scholar 

  44. WHO. Global Adult Tobacco Survey (GATS) India country report 2009–2010.

  45. WHO. Global youth tobacco survey -India country report. 2006.

  46. Reddy KS, Perry CL, Stigler MH, Arora M. Differences in tobacco use among young people in urban India by sex, socioeconomic status, age, and school grade: assessment of baseline survey data. Lancet. 2006;367:589–94.

    Article  PubMed  Google Scholar 

  47. The Health Consequences of Involuntary Exposure to Tobacco Smoke- A Report of the Surgeon General, P. H. S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health: Atlanta; 2006.

  48. Thomas RE, Baker P, Lorenzetti D. Family-based programmes for preventing smoking by children and adolescents. Cochrane Database Syst Rev. 2007;1:CD004493.

    PubMed  Google Scholar 

  49. Adolescents NHBPEPWGoHBPiCa. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114:555–76.

    Article  Google Scholar 

  50. Raj M, Sundaram KR, Paul M, Deepa AS, Kumar RK. Obesity in Indian children: time trends and relationship with hypertension. Natl Med J India. 2007;20:288–93.

    PubMed  Google Scholar 

  51. Toschke AM, Kohl L, Mansmann U, von Kries R. Meta-analysis of blood pressure tracking from childhood to adulthood and implications for the design of intervention trials. Acta Paediatr. 2010;99:24–9.

    PubMed  CAS  Google Scholar 

  52. Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation. 2008;117:3171–80.

    Article  PubMed  Google Scholar 

  53. Johnson MC, Bergersen LJ, Beck A, Dick G, Cole BR. Diastolic function and tachycardia in hypertensive children. Am J Hypertens. 1999;12:1009–14.

    Article  PubMed  CAS  Google Scholar 

  54. Laird WP, Fixler DE. Left ventricular hypertrophy in adolescents with elevated blood pressure: assessment by chest roentgenography, electrocardiography, and echocardiography. Pediatrics. 1981;67:255–9.

    PubMed  CAS  Google Scholar 

  55. Sorof JM, Alexandrov AV, Cardwell G, Portman RJ. Carotid artery intimal-medial thickness and left ventricular hypertrophy in children with elevated blood pressure. Pediatrics. 2003;111:61–6.

    Article  PubMed  Google Scholar 

  56. Lauer RM, Clarke WR. Use of cholesterol measurements in childhood for the prediction of adult hypercholesterolemia. The Muscatine Study. JAMA. 1990;264:3034–8.

    Article  PubMed  CAS  Google Scholar 

  57. Webber LS, Srinivasan SR, Wattigney WA, Berenson GS. Tracking of serum lipids and lipoproteins from childhood to adulthood. The Bogalusa Heart Study. Am J Epidemiol. 1991;133:884–99.

    PubMed  CAS  Google Scholar 

  58. Williams CL, Hayman LL, Daniels SR, et al. Cardiovascular health in childhood: a statement for health professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 2002;106:143–60.

    Article  PubMed  Google Scholar 

  59. Belay B, Belamarich P, Racine AD. Pediatric precursors of adult atherosclerosis. Pediatr Rev. 2004;25:4–16.

    Article  PubMed  Google Scholar 

  60. Slattery ML, Schumacher MC, Hunt SC, Williams RR. The associations between family history of coronary heart disease, physical activity, dietary intake and body size. Int J Sports Med. 1993;14:93–9.

    Article  PubMed  CAS  Google Scholar 

  61. Crea F, Gaspardone A, Tomai F, et al. Risk factors in schoolchildren associated with a family history of unheralded myocardial infarction or uncomplicated stable angina in male relatives. J Am Coll Cardiol. 1994;23:1472–8.

    Article  PubMed  CAS  Google Scholar 

  62. Ebrahim S, Beswick A, Burke M, Davey Smith G. Multiple risk factor interventions for primary prevention of coronary heart disease. Cochrane Database Syst Rev. 2011;1:CD001561.

    PubMed  Google Scholar 

  63. DeMattia L, Lemont L, Meurer L. Do interventions to limit sedentary behaviours change behaviour and reduce childhood obesity? a critical review of the literature. Obes Rev. 2007;8:69–81.

    Article  PubMed  CAS  Google Scholar 

  64. Harrell JS, Gansky SA, McMurray RG, Bangdiwala SI, Frauman AC, Bradley CB. School-based interventions improve heart health in children with multiple cardiovascular disease risk factors. Pediatrics. 1998;102:371–80.

    Article  PubMed  CAS  Google Scholar 

  65. Matsudo SM, Matsudo VR, Araujo TL, et al. The Agita São Paulo Program as a model for using physical activity to promote health. Rev Panam Salud Publica. 2003;14:265–72.

    Article  PubMed  Google Scholar 

  66. Flay BR. The promise of long-term effectiveness of school-based smoking prevention programs: a critical review of reviews. Tob Induc Dis. 2009;5:7.

    Article  PubMed  Google Scholar 

  67. Arora M, Stigler MH, Reddy KS. Effectiveness of health promotion in preventing tobacco use among adolescents in India: research evidence informs the National Tobacco Control Programme in India. Glob Health Promot. 2011;18:9–12.

    Article  PubMed  Google Scholar 

  68. Kavey RE, Daniels SR, Lauer RM, Atkins DL, Hayman LL, Taubert K, American Heart Association. American Heart Associations guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. Circulation. 2003;107:1562–6.

    Article  PubMed  Google Scholar 

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Role of Funding Source

D Prabhakaran (Corresponding Author) is supported with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Department of Health and Human Services, under Contract No.HHSN268200900026C, and the United Health Group, Minneapolis, Mn, USA; D43 NCDs in India Training Program (Award Number 1D43HD05249) from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) and Fogarty International Centre; and The European Commission Grant (Grant Award number 241849).

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Correspondence to Dorairaj Prabhakaran.

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Praveen, P.A., Roy, A. & Prabhakaran, D. Cardiovascular Disease Risk Factors: A Childhood Perspective. Indian J Pediatr 80 (Suppl 1), 3–12 (2013). https://doi.org/10.1007/s12098-012-0767-z

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