Pediatric Cardiology

, Volume 40, Issue 6, pp 1113–1125 | Cite as

Lifestyles and Cardiovascular Prevention in Childhood and Adolescence

  • Maurizio Giuseppe AbrignaniEmail author
  • Fabiana Lucà
  • Silvia Favilli
  • Manuela Benvenuto
  • Carmelo Massimiliano Rao
  • Stefania Angela Di Fusco
  • Domenico Gabrielli
  • Michele Massimo Gulizia
  • On behalf of Cardiovascular Prevention Area, Young Cardiologists Area, and Paediatric Cardiology Task Force of the Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), and Heart Care Foundation
Review Article


Pathology studies demonstrated that coronary fatty streaks develop early in life and that even more advanced fibrous plaques are present in a proportion of adolescents. The presence and extent of atherosclerosis in children and adolescents can be correlated with the same risk factors present in adults; as well as, childhood levels of these risk factors predict adult cardiovascular diseases. Children are born with ideal cardiovascular health but, unfortunately, most of them develop over time modifiable behavioral risk factors. Achieving sustained lifestyle changes initiated too late in adults is difficult, and pharmacologic risk factor control cannot fully restore a low-risk state. Therefore, it seems eminently reasonable to initiate healthful lifestyle training as early in life, decreasing the prevalence of cardiovascular risk factors to retard atherogenic processes and reduce the future burden of cardiovascular diseases. Many guideline recommendations encourage universal adoption of healthier lifestyles, identification of children with cardiovascular risk factors, and their treatment using targeted lifestyle modification and, rarely, pharmacotherapy. Major gains will likely accrue from public health strategies targeting incorrect diet, physical activity, and cigarette smoking. Individualized strategies, however, will initially focus on the highest risk children such as those with familial hyperlipidaemia, diabetes, hypertension, and obesity. The primary purpose of this article is to provide a broad overview on the long-term cardiovascular effects of risk factors in children and youth and to outline various lines of evidence for the efficacy of primordial and primary prevention in young people, as well as recommendations for population- and individual-level strategies and evidence-based interventions.


Children Adolescents Cardiovascular prevention Primordial prevention 



We thank the directive and the national Boards of the ANMCO for having endorsed this document.

Compliance with Ethical Standards:

Conflict of interest

All authors report no relationships that could be construed as a conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Maurizio Giuseppe Abrignani
    • 1
    Email author
  • Fabiana Lucà
    • 2
  • Silvia Favilli
    • 3
  • Manuela Benvenuto
    • 4
  • Carmelo Massimiliano Rao
    • 2
  • Stefania Angela Di Fusco
    • 5
  • Domenico Gabrielli
    • 6
  • Michele Massimo Gulizia
    • 7
  • On behalf of Cardiovascular Prevention Area, Young Cardiologists Area, and Paediatric Cardiology Task Force of the Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), and Heart Care Foundation
  1. 1.O.U. of CardiologyP.O. S. Antonio Abate Di Trapani, ASP TrapaniMarsalaItaly
  2. 2.O.U. of CardiologyGrande Ospedale Metropolitano, Azienda Ospedaliera Bianchi Melacrino MorelliReggio CalabriaItaly
  3. 3.O.U. of CardiologyA.O.U. MeyerFlorenceItaly
  4. 4.O.U. of CardiologyOspedale Civile Giuseppe MazziniTeramoItaly
  5. 5.O.U. of CardiologyP.O. S. Filippo NeriRomeItaly
  6. 6.O.U. of CardiologyOspedale Civile A. MurriFermoItaly
  7. 7.O.U. of CardiologyP.O. Garibaldi NesimaCataniaItaly

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