Promoting Ideal Cardiovascular Health Through the Life Span

Abstract

* Abbreviations: cIMT — : carotid intima-media thickness CVH — : cardiovascular health ECHO — : Environmental Influences on Child Health Outcomes HDL — : high density lipoprotein NHLBI — : National Heart, Lung, and Blood Institute Atherosclerotic cardiovascular disease is the leading cause of morbidity and mortality in the United States and worldwide.1 Because lipids in children and adolescents play a role in the development of atherosclerosis, many researchers have focused on whether screening blood lipid levels in youth could contribute to prevention of adult cardiovascular disease.2,3 One understudied issue has been the relationship between lipid levels in youth and markers of atherosclerosis in adulthood. In this issue of Pediatrics , Juonala et al4 report the relationship between non–high density lipoprotein (HDL) cholesterol levels in childhood and high carotid intima-media thickness (cIMT) in adulthood. Participants included 4582 females and males from 4 cohort studies (3 international and 1 domestic) that collected data at ages 3 to 19 years and again in adulthood, an average of 26 years later. The authors found some relationships between non-HDL cholesterol levels among adolescents ≥15 years old and high cIMT during adulthood. For example, across all 4 cohorts, the adjusted relative risk among 15- to 17-year-olds with dyslipidemia was 1.72 (95% confidence interval: 1.08–2.72). The relative risks for participants with improved levels from youth to adulthood were lower than the relative risks for those who had persistently high levels, suggesting that reduction in non-HDL cholesterol over time can improve the atherosclerotic burden. Despite these observed relationships, the findings … Address correspondence to S. Sonia Arteaga, PhD, Environmental Influences on Child Health Outcomes Program, Office of the Director, National Institutes of Health, 3 White Flint North, 11601 Landsdown St, North Bethesda, MD 20852. E-mail: sonia.arteaga{at}nih.gov