Skip to main content

Epidemiology of Cardiovascular Disease in Children

  • Reference work entry
  • First Online:
Book cover Pediatric Hypertension
  • 1186 Accesses

Abstract

Atherosclerosis, the major cause of acquired cardiovascular disease, has its origins in childhood. The development of early atherosclerosis is directly related to the major cardiovascular risk factors: hypertension, dyslipidemia, tobacco use, diabetes, obesity, and physical inactivity. The presence of risk factors in childhood is associated with measures of subclinical atherosclerosis later in life, and risk factors assessed in children are highly likely to persist into adulthood. Thresholds for optimal levels of cardiovascular risk factors in childhood have been developed, and evidence-based strategies for the management of cardiovascular risk in childhood have been published.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • Anonymous (2001) Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA 285:2486–2497

    Article  Google Scholar 

  • Anonymous (2003a) Management of dyslipidemia in children and adolescents with diabetes. Diabetes Care 26:2194–2197

    Article  Google Scholar 

  • Anonymous (2003b) Seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC VII). Hypertension 42:1206–1252

    Google Scholar 

  • Anonymous (2011) Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 128(Suppl 5):S213–S256

    Google Scholar 

  • Anonymous (2012) Preventing tobacco use among youth and young adults: a report of the surgeon general. In: U.S. Department of Health and Human Services CfDCaP, National Center for Chronic, Disease Prevention and health Promotion OoSaH (eds) Atlanta

    Google Scholar 

  • Anonymous (2013a) Lipid and inflammatory cardiovascular risk worsens over 3 years in youth with type 2 diabetes: the TODAY clinical trial. Diabetes Care 36:1758–1764

    Article  Google Scholar 

  • Anonymous (2013b) Rapid rise in hypertension and nephropathy in youth with type 2 diabetes: the TODAY clinical trial. Diabetes Care 36:1735–1741

    Article  Google Scholar 

  • Anonymous (2015) 2015–2020 dietary guidelines for Americans. 8th edition. In: USDoHaHSaUSDo (ed) Agriculture. U.S. Government Printing Office, Washington, DC

    Google Scholar 

  • Balagopal PB, De Ferranti SD, Cook S et al (2011) Nontraditional risk factors and biomarkers for cardiovascular disease: mechanistic, research, and clinical considerations for youth: a scientific statement from the American Heart Association. Circulation 123:2749–2769

    Article  Google Scholar 

  • Barrington-Trimis JL, Urman R, Leventhal AM et al (2016) E-cigarettes, cigarettes, and the prevalence of adolescent tobacco use. Pediatrics 138(2):e20153983

    Article  PubMed  Google Scholar 

  • Carnethon MR, Gidding SS, Nehgme R et al (2003) Cardiorespiratory fitness in young adulthood and the development of cardiovascular disease risk factors. JAMA 290:3092–3100

    Article  CAS  Google Scholar 

  • Celermajer DS (2008) Reliable endothelial function testing: at our fingertips? Circulation 117:2428–2430

    Article  Google Scholar 

  • Chen X, Wang Y (2008) Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation 117:3171–3180

    Article  PubMed  Google Scholar 

  • Cohen JC, Boerwinkle E, Mosley TH Jr et al (2006) Sequence variations in PCSK9, low LDL, and protection against coronary heart disease. N Engl J Med 354:1264–1272

    Article  CAS  Google Scholar 

  • Dabelea D, Bell RA, D’agostino RB Jr et al (2007) Incidence of diabetes in youth in the United States. JAMA 297:2716–2724

    Article  Google Scholar 

  • De Ferranti SD, De Boer IH, Fonseca V et al (2014) Type 1 diabetes mellitus and cardiovascular disease: a scientific statement from the American Heart Association and American Diabetes Association. Circulation 130:1110–1130

    Article  Google Scholar 

  • Deloach S, Keith SW, Gidding SS et al (2014) Obesity associated inflammation in African American adolescents and adults. Am J Med Sci 347:357–363

    Article  PubMed  Google Scholar 

  • Elders MJ, Perry CL, Eriksen MP et al (1994) The report of the surgeon general: preventing tobacco use among young people. Am J Public Health 84:543–547

    Article  CAS  PubMed  Google Scholar 

  • Erqou S, Kaptoge S, Perry PL et al (2009) Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality. JAMA 302:412–423

    Article  CAS  Google Scholar 

  • Ference BA, Yoo W, Alesh I et al (2012) Effect of long-term exposure to lower low-density lipoprotein cholesterol beginning early in life on the risk of coronary heart disease: a Mendelian randomization analysis. J Am Coll Cardiol 60:2631–2639

    Article  CAS  Google Scholar 

  • Gaeta G, De Michele M, Cuomo S et al (2000) Arterial abnormalities in the offspring of patients with premature myocardial infarction. N Engl J Med 343:840–846

    Article  CAS  Google Scholar 

  • Garrett BE, Dube SR, Trosclair A et al (2011) Cigarette smoking – United States, 1965–2008. MMWR Surveill Summ 60(Suppl):109–113

    Google Scholar 

  • Gidding S (2007) Noninvasive cardiac imaging: implications for risk assessment in adolescents and young adults. Ann Med 18

    Google Scholar 

  • Gidding SS, Sood E (2015) Preventing cardiovascular disease: going beyond conventional risk assessment. Circulation 131:230–231

    Article  Google Scholar 

  • Gidding SS, Bookstein LC, Chomka EV (1998a) Usefulness of electron beam tomography in adolescents and young adults with heterozygous familial hypercholesterolemia. Circulation 98:2580–2583

    Article  CAS  Google Scholar 

  • Gidding SS, Stone NJ, Bookstein LC et al (1998b) Month-to-month variability of lipids, lipoproteins, and apolipoproteins and the impact of acute infection in adolescents. J Pediatr 133:242–246

    Article  CAS  Google Scholar 

  • Gidding SS, Dennison BA, Birch LL et al (2005) Dietary recommendations for children and adolescents: a guide for practitioners: consensus statement from the American Heart Association. Circulation 112:2061–2075

    Article  CAS  Google Scholar 

  • Gidding SS, Barton BA, Dorgan JA et al (2006a) Higher self-reported physical activity is associated with lower systolic blood pressure: the Dietary Intervention Study in Childhood (DISC). Pediatrics 118:2388–2393

    Article  Google Scholar 

  • Gidding SS, Mcmahan CA, Mcgill HC et al (2006b) Prediction of coronary artery calcium in young adults using the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) risk score: the CARDIA Study. Arch Intern Med 166:2341–2347

    Article  CAS  Google Scholar 

  • Gidding SS, Lichtenstein AH, Faith MS et al (2009) Implementing American Heart Association pediatric and adult nutrition guidelines: a scientific statement from the American Heart Association Nutrition Committee of the council on nutrition, physical activity and metabolism, council on cardiovascular disease in the young, council on arteriosclerosis, thrombosis and vascular biology, council on cardiovascular nursing, council on epidemiology and prevention, and council for high blood pressure research. Circulation 119:1161–1175

    Article  Google Scholar 

  • Gidding SS, Liu K, Colangelo LA et al (2013) Longitudinal determinants of left ventricular mass and geometry: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Circ Cardiovasc Imaging 6:769–775

    Article  Google Scholar 

  • Gidding SS, Ann Champagne M, De Ferranti SD et al (2015a) The agenda for familial hypercholesterolemia: a scientific statement from the American Heart Association. Circulation 132:2167–2192

    Article  Google Scholar 

  • Gidding SS, Keith SW, Falkner B (2015b) Adolescent and adult African Americans have similar metabolic dyslipidemia. J Clin Lipidol 9:368–376

    Article  Google Scholar 

  • Gidding SS, Rana J, Prendergast C, Mcgill H, Carr JJ, Liu K, Colangelo L, Loria CM, Lima J, Terry JG, Reis JP, Mcmahan CA (2016) Pathobiological Determinants of Atherosclerosis in Youth (PDAY) risk score in young adults predicts coronary artery and abdominal aorta calcium in Middle Age. The CARDIA Study. Circulation 133:139–146

    Article  Google Scholar 

  • Greenland P, Alpert JS, Beller GA et al (2010) 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: executive summary: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. Circulation 122:2748–2764

    Article  Google Scholar 

  • He FJ, Macgregor GA (2006) Importance of salt in determining blood pressure in children: meta-analysis of controlled trials. Hypertension 48:861–869

    Article  CAS  Google Scholar 

  • Jolliffe CJ, Janssen I (2006) Distribution of lipoproteins by age and gender in adolescents. Circulation 114:1056–1062

    Article  CAS  Google Scholar 

  • Juonala M, Magnussen CG, Berenson GS et al (2011) Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med 365:1876–1885

    Article  CAS  Google Scholar 

  • Kelley GA, Kelley KS, Tran ZV (2003) The effects of exercise on resting blood pressure in children and adolescents: a meta-analysis of randomized controlled trials. Prev Cardiol 6:8–16

    Article  PubMed  Google Scholar 

  • Labarthe DR, Nichaman MZ, Harrist RB et al (1997) Development of cardiovascular risk factors from ages 8 to 18 in project HeartBeat! Study design and patterns of change in plasma total cholesterol concentration. Circulation 95:2636–2642

    Article  CAS  Google Scholar 

  • Lauer RM, Clarke WR (1990) Use of cholesterol measurements in childhood for the prediction of adult hypercholesterolemia. The Muscatine Study. JAMA 264:3034–3038

    Article  CAS  Google Scholar 

  • Li S, Chen W, Srinivasan SR et al (2003) Childhood cardiovascular risk factors and carotid vascular changes in adulthood: the Bogalusa Heart Study. JAMA 290:2271–2276

    Article  CAS  Google Scholar 

  • Lynch EB, Liu K, Kiefe CI et al (2006) Cardiovascular disease risk factor knowledge in young adults and 10-year change in risk factors: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Epidemiol 164:1171–1179

    Article  Google Scholar 

  • Maahs DM, Daniels SR, De Ferranti SD et al (2014) Cardiovascular disease risk factors in youth with diabetes mellitus: a scientific statement from the American Heart Association. Circulation 130:1532–1558

    Article  Google Scholar 

  • Mahoney LT, Burns TL, Stanford W et al (1996) 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 27:277–284

    Article  CAS  Google Scholar 

  • Mccrindle BW, Urbina EM, Dennison BA et al (2007) Drug therapy of high-risk lipid abnormalities in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee, Council of Cardiovascular Disease in the Young, with the Council on Cardiovascular Nursing. Circulation 115:1948–1967

    Article  Google Scholar 

  • Mcgill HC Jr, Mcmahan CA, Tracy RE et al (1998) Relation of a postmortem renal index of hypertension to atherosclerosis and coronary artery size in young men and women. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Arterioscler Thromb Vasc Biol 18:1108–1118

    Article  Google Scholar 

  • Mcgill HC Jr, Mcmahan CA, Zieske AW et al (2001) Effects of nonlipid risk factors on atherosclerosis in youth with a favorable lipoprotein profile. Circulation 103:1546–1550

    Article  CAS  Google Scholar 

  • Mcgill HC Jr, Mcmahan CA, Herderick EE et al (2002) Obesity accelerates the progression of coronary atherosclerosis in young men. Circulation 105:2712–2718

    Article  Google Scholar 

  • Mcgill HC Jr, Mcmahan CA, Gidding SS (2008) Preventing heart disease in the 21st century: implications of the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Study. Circulation 117:1216–1227

    Article  Google Scholar 

  • Mcmahan CA, Gidding SS, Fayad ZA et al (2005) Risk scores predict atherosclerotic lesions in young people. Arch Intern Med 165:883–890

    Article  Google Scholar 

  • Mcmahan CA, Gidding SS, Malcom GT et al (2006) Pathobiological determinants of atherosclerosis in youth risk scores are associated with early and advanced atherosclerosis. Pediatrics 118:1447–1455

    Article  Google Scholar 

  • Mcmahan CA, Gidding SS, Viikari JS et al (2007) Association of pathobiologic determinants of atherosclerosis in youth risk score and 15-year change in risk score with carotid artery intima-media thickness in young adults (from the Cardiovascular Risk in Young Finns Study). Am J Cardiol 100:1124–1129

    Article  PubMed  Google Scholar 

  • Messiah SE, Arheart KL, Luke B et al (2008) Relationship between body mass index and metabolic syndrome risk factors among US 8- to 14-year-olds, 1999 to 2002. J Pediatr 153:215–221

    Article  Google Scholar 

  • Morrison JA, Friedman LA, Wang P et al (2008) Metabolic syndrome in childhood predicts adult metabolic syndrome and type 2 diabetes mellitus 25 to 30 years later. J Pediatr 152:201–206

    Article  CAS  Google Scholar 

  • Muntner P, He J, Cutler JA et al (2004) Trends in blood pressure among children and adolescents. JAMA 291:2107–2113

    Article  CAS  Google Scholar 

  • Niinikoski H, Lagstrom H, Jokinen E et al (2007) Impact of repeated dietary counseling between infancy and 14 years of age on dietary intakes and serum lipids and lipoproteins: the STRIP study. Circulation 116:1032–1040

    Article  CAS  Google Scholar 

  • Nordestgaard BG (2016) Triglyceride-rich lipoproteins and atherosclerotic cardiovascular disease: new insights from epidemiology, genetics, and biology. Circ Res 118:547–563

    Article  CAS  Google Scholar 

  • Norman M (2008) Low birth weight and the developing vascular tree: a systematic review. Acta Paediatr 97:1165–1172

    Article  Google Scholar 

  • O’donnell CJ (2004) Family history, subclinical atherosclerosis, and coronary heart disease risk: barriers and opportunities for the use of family history information in risk prediction and prevention. Circulation 110:2074–2076

    Article  Google Scholar 

  • Parekh RS, Gidding SS (2005) Cardiovascular complications in pediatric end-stage renal disease. Pediatr Nephrol 20:125–131

    Article  Google Scholar 

  • Raitakari OT, Juonala M, Kahonen M et al (2003) Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA 290:2277–2283

    Article  CAS  Google Scholar 

  • Rasouli N, Kern PA (2008) Adipocytokines and the metabolic complications of obesity. J Clin Endocrinol Metab 93:S64–S73

    Article  CAS  PubMed  Google Scholar 

  • Razak F, Anand SS, Shannon H et al (2007) Defining obesity cut points in a multiethnic population. Circulation 115:2111–2118

    Article  Google Scholar 

  • Ridker PM (2007) Inflammatory biomarkers and risks of myocardial infarction, stroke, diabetes, and total mortality: implications for longevity. Nutr Rev 65:S253–S259

    Article  Google Scholar 

  • Robinson JG, Gidding SS (2014) Curing atherosclerosis should be the next major cardiovascular prevention goal. J Am Coll Cardiol 63:2779–2785

    Article  Google Scholar 

  • Rodenburg J, Vissers MN, Wiegman A et al (2007) Statin treatment in children with familial hypercholesterolemia: the younger, the better. Circulation 116:664–668

    Article  CAS  Google Scholar 

  • Roman MJ, Naqvi TZ, Gardin JM et al (2006) American Society of Echocardiography report. Clinical application of noninvasive vascular ultrasound in cardiovascular risk stratification: a report from the American Society of Echocardiography and the Society for Vascular Medicine and Biology. Vasc Med 11:201–211

    Article  Google Scholar 

  • Steinberg D, Gotto AM Jr (1999) Preventing coronary artery disease by lowering cholesterol levels: fifty years from bench to bedside. JAMA 282:2043–2050

    Article  CAS  Google Scholar 

  • Steinberger J, Daniels SR (2003) Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (council on cardiovascular disease in the young) and the diabetes Committee (council on nutrition, physical activity, and metabolism). Circulation 107:1448–1453

    Article  Google Scholar 

  • Urbina EM, Williams RV, Alpert BS et al (2009) Noninvasive assessment of subclinical atherosclerosis in children and adolescents: recommendations for standard assessment for clinical research: a scientific statement from the American Heart Association. Hypertension 54:919–950

    Article  CAS  Google Scholar 

  • Urbina EM, Gao Z, Khoury PR et al (2012) Insulin resistance and arterial stiffness in healthy adolescents and young adults. Diabetologia 55:625–631

    Article  CAS  Google Scholar 

  • Wang TJ, Nam BH, D’agostino RB et al (2003) Carotid intima-media thickness is associated with premature parental coronary heart disease: the Framingham Heart Study. Circulation 108:572–576

    Article  Google Scholar 

  • Wiegman A, Hutten BA, De Groot E et al (2004) Efficacy and safety of statin therapy in children with familial hypercholesterolemia: a randomized controlled trial. JAMA 292:331–337

    Article  CAS  Google Scholar 

  • Wiegman A, Gidding SS, Watts GF et al (2015) Familial hypercholesterolaemia in children and adolescents: gaining decades of life by optimizing detection and treatment. Eur Heart J 36:2425–2437

    Article  PubMed  Google Scholar 

  • Williams CL, Hayman LL, Daniels SR et al (2002) 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 106:143–160

    Article  Google Scholar 

  • Winkleby MA, Robinson TN, Sundquist J et al (1999) Ethnic variation in cardiovascular disease risk factors among children and young adults: findings from the third National Health and nutrition examination survey, 1988–1994. JAMA 281:1006–1013

    Article  CAS  Google Scholar 

  • Zappalla FR, Gidding SS (2009) Lipid management in children. Endocrinol Metab Clin N Am 38:171–183

    Article  CAS  Google Scholar 

  • Zeitler P, Hirst K, Pyle L et al (2012) A clinical trial to maintain glycemic control in youth with type 2 diabetes. N Engl J Med 366:2247–2256

    Article  CAS  Google Scholar 

  • Zieske AW, Mcmahan CA, Mcgill HC Jr et al (2005) Smoking is associated with advanced coronary atherosclerosis in youth. Atherosclerosis 180:87–92

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Samuel S. Gidding .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Gidding, S.S. (2018). Epidemiology of Cardiovascular Disease in Children. In: Flynn, J., Ingelfinger, J., Redwine, K. (eds) Pediatric Hypertension. Springer, Cham. https://doi.org/10.1007/978-3-319-31107-4_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-31107-4_13

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31106-7

  • Online ISBN: 978-3-319-31107-4

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics