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Atherosclerosis Starts in Children and Young Adults.

Louisiana's Bogalusa Heart Study is a long-term epidemiologic study that has collected cardiovascular risk- factor data on approximately 14,000 children and young adults for several decades. This report correlates those data with aortic and coronary autopsy findings in 93 subjects who died at an average age of 20 (mostly from accidents and homicide).

Fatty streaks were found in the aortas and coronary arteries of most subjects. In those aged 2 to 15, the prevalence of raised fibrous plaques was about 20 percent in the aorta and 8 percent in the coronary arteries; these figures rose to 60 percent and 69 percent, respectively, by ages 26 to 39. Body mass index, systolic blood pressure, triglycerides, and LDL cholesterol were the risk factors most strongly correlated with aortic and coronary lesions. Those with multiple risk factors had more extensive lesions than those with zero or one risk factor. Although there were only 15 documented smokers among these young people, smokers tended to have more extensive fibrous plaques than nonsmokers.

Comment: This study adds to previous evidence suggesting that the earliest atherosclerotic changes begin in childhood and correlate with traditional risk factors. An editorialist believes that the data support intensified efforts to promote healthy eating, ideal weight, exercise, and smoking prevention in children.

— AS Brett

Published in Journal Watch General Medicine June 9, 1998

Citation(s):

Berenson GS et al. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med 1998 Jun 338 1650-1656.

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Gaziano JM. When should heart disease prevention begin?. N Engl J Med 1998 Jun 338 1690-1691.

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• Medline abstract (Free)