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AHA Advocates Atherosclerosis Assessment in Children

Scientific statement recommends standardized tools and procedures to identify those at risk

FRIDAY, Sept. 4 (HealthDay News) -- In a scientific statement published online Sept. 3 in Hypertension, the American Heart Association has promulgated recommendations for a standardized approach to the noninvasive assessment of children and adolescents for the earliest signs of approaching atherosclerosis.

Elaine Urbina, M.D., of the Cincinnati Children's Hospital Medical Center, and colleagues on the AHA Atherosclerosis, Hypertension, and Obesity in Youth Committee reviewed the literature on atherosclerosis in adolescents and children and offered recommendations for standardized assessment tools and procedures to identify those at risk, as well as stimulate research to develop normative data for the pediatric population.

The AHA statement identifies changes in arterial structure, stiffness, and function as early events in the pathogenesis of cardiovascular disease that can be detected in young patients. To evaluate structure, the statement advocates measurement of carotid intimal and medial thickness using high-resolution B-mode ultrasound and measurement of coronary artery calcification with computed tomography imaging. Ultrasound, MRI, ECG-gated oscillometric cuff technology, or pressure tonometers can be used to measure arterial stiffness, while arterial function can be measured using ultrasound.

"The ability to use noninvasive methods to accurately measure vascular damage related to atherosclerotic processes in youth will substantially improve our ability to risk-stratify individuals by traditional assessment, especially in this youthful population in which hard cardiovascular end points are unlikely to occur. Improved risk profiling will allow targeting of the highest-risk youth for the most aggressive interventions to prevent myocardial infarction and stroke," the authors write.

Two co-authors reported having received consulting fees from pharmaceutical companies in the past.

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