Cardiovascular risk factors in children. Should they concern the pediatrician?
G. S. Berenson, G. C. Frank, S. M. Hunter, S. R. Srinivasan, A. W. Voors and L. S. Webber
There is evidence that atherosclerosis, coronary artery disease, and
essential hypertension begin early in life. The Bogalusa (La) Heart Study
has examined cardiovascular risk factors and their determinants during the
pediatric age span in a total community study. Reliable measurements were
obtained and then analyzed to identify "tracking" of risk factors over time
and clusters or aggregations of various risk factors at high levels. Serum
lipoprotein levels, obesity, BP, and plasma insulin levels were all
correlated after a glucose load, implying causal interrelationships.
Although such relationship are only partly elucidated, the associations
potentially enhance premature atherosclerosis. Certain kinds of behavior,
for example cigarette smoking and type A behavior, may also contribute to
early coronary artery disease. Our observations suggest that practicing
physicians should assess risk factors in children and encourage changes in
life-style to combat the high incidence of coronary artery disease and
essential hypertension in the United States.
