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Call to Start Heart Disease Prevention in Childhood

NEW YORK (Reuters Health) - Baby's first steps are a big day for parents, and a development milestone marked by pediatricians. A new report suggests that parents and doctors need to recognize another important set of steps during childhood: steps taken to prevent the number one killer, heart disease.

Teenagers and young adults who smoke, have high cholesterol, high blood pressure or are overweight are already at risk for fatty plaque deposits in their arteries, researchers note in the July 25th issue of Circulation: Journal of the American Heart Association. Such fatty deposits increase a person's risk of having a heart attack.

``Our study indicates that hardening of the arteries starts in childhood and risk factors accelerate it in adolescence,'' according to study co-author Dr. Henry C. McGill, Jr., of the Southwest Foundation for Biomedical Research in San Antonio, Texas. ``Long range prevention needs to start early,'' he told Reuters Health in an interview.

The research team examined the heart arteries of 760 men and women aged 15 to 34 who died due to an accident, homicide or suicide. The researchers then determined the heart risk factors of each individual studied, including smoking, high blood pressure, high cholesterol and obesity.

``The people with high levels of LDL (low density lipoprotein) cholesterol, or 'bad cholesterol' were the most likely to have extensive build-up of plaques in their arteries,'' McGill told Reuters Health. The investigators found that 20% of the men aged 30 to 34 had advanced stages of plaque while only 2% of men aged 15 to 19 did. They also found 8% of the women aged 30 to 34 had advanced stages of plaques. Researchers did not find serious amounts of plaque in the arteries of women aged 15 to 19.

Steps that can prevent heart disease later in life include not smoking or stopping smoking, maintaining a normal weight, and treating diseases that increase risk such as diabetes and high blood cholesterol.

The study results suggest that ``a large number of young people are at above-average risk of precocious atherosclerosis and eventual (coronary heart disease),'' the researchers write.

``Although changing the behavior of young people is a difficult task, available information indicates that the earlier the cardiovascular risk factors are modified, the greater the potential for deferring the onset of coronary heart disease,'' the authors write. ``Prevention of (heart disease) is, indeed, a pediatric problem.''

In an interview with Reuters Health, Dr. James Moller, a spokesperson for the American Heart Association, said, ``I think the main public health message is that we need to help children acquire healthy eating and exercise habits. By exercise I don't mean running marathons and doing the stair-climbing machine at the gym. I am talking about families taking long walks or going on bike rides,'' he explained.

``Parents, schools and physicians have a role in trying to create an environment where kids can grow up healthy,'' Moller added.

SOURCE: Circulation 2000;102.

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