Heart Disease Starts in Childhood

Risk factors found in kids can predict problems in adulthood

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By
HealthDay Reporter

MONDAY, Nov. 4, 2003 (HealthDayNews) -- The risk factors for heart attack and stroke in adults often show up in childhood, and doctors and parents can take action now to provide protection decades later, new research says.

"Like the real estate people say, 'location, location, location' -- it's lifestyle, lifestyle, lifestyle,'" says Dr. Henry C. McGill, a senior scientist emeritus at the Southwestern Foundation for Biomedical Research in Texas, who has done work on the subject of children and heart disease for decades.

McGill is coauthor of an editorial in the Nov. 5 issue of the Journal of the American Medical Association on two new studies linking risk factors evident in children that can help predict heart problems later in life. Specifically, warning signs such as high blood cholesterol and high blood pressure can help predict another well-known risk factor found in adults -- abnormal thickness of the carotid artery, the main blood vessel to the brain.

One report comes from the Bogalusa Heart Study, which has followed residents of a Louisiana community for years. It says increased carotid artery thickness -- in formal medical terms, intima-media thickness, or IMT -- in adults can be presaged by high blood cholesterol and high blood pressure in children and teens.

High childhood blood levels of LDL cholesterol, the "bad" kind that clogs arteries, "was the most consistent and independent predictor of carotid IMT in young adults," the researchers say.

The second study, done by physicians at the University of Turku in Finland, involved measurements of standard adult risk factors -- high cholesterol, blood pressure, obesity, smoking -- done on more than 2,200 children and adolescents in 1980 and then repeated on the same group 21 years later.

"Our findings indicate that children and adolescents with several risk factors are at increased risk of developing atherosclerosis in adulthood," the Finnish researchers write. Atherosclerosis is the process in which fatty deposits stiffen and clog blood vessels, leading to heart attacks and stroke.

The issue of predicting heart disease in adults based on measurements taken in childhood has aroused some controversy through the years, McGill says. "Most of the controversy has been over whether measuring cholesterol in these children can predict risk in adult life," he says. "Evidence piled up in the last few years shows that it does."

But McGill says cholesterol readings often aren't needed to sound a warning for parents.

"It doesn't take an intensive laboratory test to tell if a kid is smoking," he says. "You can tell if a kid is fat from 50 yards away. And parents know when a child is getting off his fanny and exercising a lot."

Dr. Gerald S. Berenson, principal investigator of the Bogalusa Heart Study and a professor of medicine, pediatrics and biochemistry at the Tulane University Health Science Center, says "the message of this study for parents is to understand that adult heart diseases start in childhood."

A distressing number of children in the Bogalusa study show the risk factors for future heart disease, he says. "On the average, they are 12 percent heavier than in 1973," Berenson says. "And 30 to 40 percent of the high school children are smoking."

McGill thinks parents and pediatricians should start paying attention to risk factors in children "at least by age 11 or 12, but you can get started before then."

Berenson favors a much earlier start.

"We recommend studying children at preschool age, when they enter school and need a physical examination," he says. "Parents should study children for every cardiovascular risk factor, particularly if they have a history of it in the family. Parents have to recognize that they should teach children a healthy lifestyle to delay or prevent adult heart disease."

More information

The American Heart Association offers tips on exercise and nutrition for children.

SOURCES: Henry C. McGill, M.D., senior scienctist emeritus, Southwestern Foundation for Biomedical Research, San Antonio; Gerald S. Berenson, M.D., principal investigator, Bogalusa Heart Study, New Orleans; Nov. 5, 2003, Journal of the American Medical Association

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