Prevention of Heart Disease in Childhood—Encouragement of Primordial Prevention

Abstract

Observations over the many years in the Bogalusa Heart Study, have established that adverse cardiovascular risk factors have their onset early in life. The most dramatic evidence of cardiovascular disease comes from autopsy studies on young individuals in Bogalusa. Such findings have been extended by the Pathologic Determinants of Atherosclerosis in Youth and very strong correlations occur at autopsy between ante mortem clinical cardiovascular risk factors and actual anatomic changes consistent with cardiovascular disease. Lifestyles that are associated with atherosclerosis and hypertension—high fat-high cholesterol diets, high salt intake, inactivity, obesity, consistent smoking (we noted by 8–9 years of age) and other poor lifestyles need to be addressed. These findings urge the medical profession, especially cardiologists, to give leadership to prevention involving children and their families. Addressing lifestyles and behavior for families including their offspring should be a high priority to break this devastating toll on our society. Although there are now many drugs available that improve medical aspects and even prolong life by treating coronary artery disease, hypertension and diabetes mellitus, improving poor lifestyles beginning at a young age could work in concert with both primary and secondary prevention. Yet, the ubiquitous prevalence of cardiovascular diseases and their beginning at an early age, show the need to improve deleterious lifestyles for all children and begin primordial prevention. Primordial prevention through public health education at the elementary school age with family involvement should be a goal for Preventive Cardiology.