Cardiovascular risk factors in adolescents

  • Gidding S
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Abstract

Most children who are normal weight for height and otherwise healthy have risk factor levels associated with the absence of heart disease (ie, they do not smoke, do not have diabetes, are physically active, have low-density lipoprotein levels < 110 mg/dL, and have blood pressure < 120/80 mm Hg). However, by adolescence, the earliest lesions in the atherosclerotic process, fatty streaks and raised lesions, are present in the coronary arteries and the abdominal aorta. The severity of early atherogenesis is related to the coexistence of the major cardiovascular risk factors. Most commonly, the associated risk disturbances are mild: borderline hypertension, mild dyslipidemia, insulin resistance, overweight, physical inactivity, and initiation of tobacco use. Rarely, more severe risk factors are present: familial hypercholesterolemia (a genetic disorder of lipid metabolism), diabetes mellitus, secondary hypertension of long standing, or risk factors associated with chronic conditions such as end-stage renal disease. Thus, cardiovascular risk management in this age group has two components: primordial prevention (the prevention of the development of cardiovascular risk in the first place) and primary prevention (more aggressive treatment of identified risk factors in high-risk individuals either through behavioral or pharmacologic means). Trials beginning in adolescence of the primary prevention of atherosclerosis-related diseases have not been undertaken; thus, the decision to initiate pharmacologic management in high-risk adolescents requires careful thought. Copyright (copyright) 2006 by Current Science Inc.

Author-supplied keywords

  • abdominal aorta
  • acetylsalicylic acid
  • adolescent
  • adolescent disease
  • amlodipine
  • angioneurotic edema
  • angiotensin receptor antagonist
  • aspirin
  • atenolol
  • atherogenesis
  • atorvastatin
  • behavior modification
  • beta adrenergic receptor blocking agent
  • bloating
  • body height
  • body weight
  • bradycardia
  • calcium channel blocking agent
  • cardiovascular disease
  • cholesterol blood level
  • colestyramine
  • constipation
  • coronary artery
  • coughing
  • diabetes mellitus
  • diastolic blood pressure
  • diet therapy
  • dipeptidyl carboxypeptidase inhibitor
  • disease severity
  • diuretic agent
  • drug contraindication
  • drug dose regimen
  • drug potentiation
  • dyslipidemia
  • electrocardiography
  • electrolyte disturbance
  • exercise
  • ezetimibe
  • familial hypercholesterolemia
  • fish oil
  • flatulence
  • flushing
  • gastrointestinal symptom
  • gynecomastia
  • hepatitis
  • high risk population
  • hospitalization
  • human
  • hydrochlorothiazide
  • hyperkalemia
  • hypertension
  • hypertriglyceridemia
  • hyperuricemia
  • immobilization
  • insulin resistance
  • kidney failure
  • lisinopril
  • liver dysfunction
  • losartan
  • low density lipoprotein cholesterol
  • malabsorption
  • medical decision making
  • mevinolin
  • myalgia
  • nicotinic acid
  • obesity
  • omega 3 fatty acid
  • physical activity
  • pravastatin
  • primary prevention
  • protein analysis
  • review
  • risk factor
  • risk management
  • simvastatin
  • smoking
  • spironolactone
  • systolic blood pressure
  • treatment indication
  • triacylglycerol

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Authors

  • S S Gidding

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