CVD risk factors on the rise in childhood


A good number of US adolescents are already at risk for cardiovascular disease. According to new data, which risk factors should clinicians have to watch most carefully? More >>

A good number of US adolescents are already at risk for cardiovascular disease (CVD), and growing evidence shows that risk factors persist into adulthood.

New data from the National Health and Nutrition Examination Survey (NHANES) reveal that although the prevalence of prehypertension or hypertension and borderline-high or high low-density lipoprotein cholesterol (LDL-C) among US adolescents did not change substantially from the period 1999-2000 to 2007-2008, the prevalence of prediabetes or diabetes increased from 9% to 23%.

Prevalence rates for prehypertension or hypertension among adolescents for the 2 periods were 17% and 13%, respectively, and for borderline high or high LDL-C were 23% and 19%, respectively.

Among 3,383 participants aged 12 to 19 years in the NHANES survey, the most prevalent CVD risk factors were overweight and obesity, with approximately one-third falling into 1 of these 2 categories. The researchers also found that 50% of the adolescents who were overweight and 60% of those with obesity had at least 1 biologic CVD risk factor in addition to their weight status during the 1999-2008 study period, as did 37% of those who were normal weight.

Specifically, the investigators calculated that during the survey period, the overall prevalence for prehypertension or hypertension was 14%; for borderline high or high LDL-C, 22%; for low high-density lipoprotein cholesterol, 6%; and for prediabetes or diabetes, 15%.

In 2011, the American Academy of Pediatrics endorsed the National Heart, Lung, and Blood Institute’s cardiovascular risk guidelines that recommend classifying children’s weight starting at 2 years and screening for diabetes all children aged 10 years and older with body mass index (BMI) above the 85th percentile, but according to a recent survey, only about half of pediatricians use BMI percentiles for children older than 2 years.

The researchers conclude that a large percentage of adolescents, regardless of the number on the scale, would benefit from interventions and programs that emphasize the importance of physical activity, healthy diet, and healthy weight maintenance so that these risk factors do not persist into adulthood.

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