Heart Disease and Our Children

Over the next several years nearly 3,000 subjects aged 15 to 34 who had died of accidents, homicides, or suicides were evaluated by autopsy for the prevalence and extent of atherosclerosis. The results of this study were recently published in the Journal of the American Medical Association (JAMA 281:727, 1999). A few key findings are provided below:

• All subjects had intimal lesions (beginning stages of atherosclerosis in the inner lining of arteries) in their aortas, the main artery that carries oxygenated blood away from the heart
• In subjects aged 15 to 19 years, 60% had coronary artery lesions (atherosclerosis in the arteries that supply blood to the heart muscle)
• In subjects aged 30 to 34 years, 70% of females and 80% of males had coronary atherosclerosis.

A few of the key conclusions provided by the PDAY researchers were:

1. Atherosclerosis begins in youth
2. Fatty streaks and clinically raised lesions increase rapidly in prevalence and extent during ages 15 to 34
3. The earlier that cardiovascular risk factors are modified the greater the potential for deferring the onset of coronary artery disease
4. Primary prevention of atherosclerosis must begin in childhood or adolescence

It should be noted that 44% of the subjects in PDAY were smokers and smoking is one of the leading risk factors for heart disease.

If atherosclerosis begins in youth, I believe that as parents we have a responsibility to educate our children about the risk factors for heart disease and to help them implement prevention strategies in an effort to prevent or delay the onset of heart disease in their own lives. And, if one of the key recommendations offered by the researchers is to modify risk factors as early as possible, do we as parents know if our children currently have one or more of the risk factors? In conclusion, primary prevention of heart disease must begin in childhood or adolescence.