Cardiovascular Health in Childhood: A Statement for Health Professionals From the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association

Abstract

C oronary heart disease remains the leading cause of death in the United States, responsible for close to half a million deaths each year.During the past two decades, convincing evidence has emerged that links defined risk factors in adults with an accelerated atherosclerotic process.Pathological data have shown that atherosclerosis begins in childhood and that the extent of atherosclerotic change in children and young adults can be correlated with the presence of the same risk factors identified in adults.It thus seems eminently reasonable to initiate healthful lifestyle training in childhood to promote improved cardiovascular health in adult life.The goal of this document is to provide strategies for promoting cardiovascular health that can be integrated into the comprehensive pediatric care of children.The following critical areas are reviewed: physical activity, obesity, insulin resistance and type II diabetes mellitus, hypertension, high blood cholesterol, and cigarette smoking.Background information, methods of assessment, and means for intervention are discussed for each major area.A cardiovascular health schedule has been developed to help the practitioner implement these suggestions within the framework of comprehensive pediatric care.Rather than labeling specific children as abnormal, strategies are directed toward promoting optimal cardiovascular health for all children. AssessmentAssessment of physical activity in children should be tailored to the individual child.Factors that must be considered include but are not limited to age, sex, race, level of sexual maturity, and physical and mental disabilities that may affect exercise participation (ie, chronic diseases or medical condi-The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel.Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.