2024-11-22 14:46:00
Cardiovascular diseases begin in childhood and it is precisely during childhood that they need to be prevented by identifying risk factors early. The alarm was raised by the Italian Society of Paediatrics (Sip) on the occasion of its national congress, underway in Florence. “Starting from 8-10 years of age, in children with risk factors, such as obesity or family predisposition, it is important to monitor the lipid profile through screening for dyslipidemia, which measures cholesterol and triglyceride levels, both risk factors for diseases cardiovascular diseases”, recall the paediatricians who have developed 5 tips to prevent cardiovascular diseases in children.
Advice: 1) Prevent overweight. Promote healthy lifestyles, with a balanced diet, physical activity starting from the youngest child, avoid smoking (even passive); 2) Monitor blood pressure. From the age of 5, include blood pressure measurement in the family pediatrician’s health assessments; 3) If the child is overweight or has hypertension it is a good idea to carry out in-depth tests; 4) Assess family predisposition. Collect an updated family history and, in case of family history of early cardiovascular pathologies or disorders of glucose metabolism (diabetes) or lipid metabolism (increased cholesterol or triglycerides) or arterial hypertension, subject the children to an in-depth evaluation; 5) High cholesterol. Starting from 8-10 years of age, introduce dyslipidemia screening in children with risk factors such as obesity or family predisposition.
‘First vascular alterations are already evident in the vessels of many subjects in the first decade of life’
Arterial hypertension and dyslipidemia are, together with diabetes mellitus, among the most frequent and important risk factors for the development of cardiovascular diseases. “Fortunately, cardiovascular events manifest themselves clinically almost exclusively in adulthood. However, the first vascular alterations, the lipid streaks, are already evident in the vessels of many subjects in the first decade of life and many risk factors, such as hypertension and dyslipidemia, if researched, they are already present in a non-negligible number of children and young people. According to some studies conducted both on an Italian and international scale, arterial hypertension in the pediatric population is around 4-5%. the incidence reaches up to 20-25%”, underlines Marco Giussani, secretary of the Sip study group on arterial hypertension and cardiovascular risk.
What should instead cause concern is overweight, which now affects an increasingly large percentage of children and adults, so much so that we are talking about a metabolic pandemic. “A child with excessive weight is already a problem, since not infrequently his condition will remain unchanged even after adolescence. In some regions of Italy, around 40% of the population between 8 and 10 years old is overweight. And this must cause concern”, warns Gianni Bona, Pediatric Clinic of the University of Eastern Piedmont. These risk conditions, if not treated, in most cases continue from childhood to adulthood. Arterial hypertension and dyslipidemia are, by far, more frequent among children and adolescents who are overweight. «Prevention must aim to identify the main cardiovascular risk factors early in individual children to treat them with a personalized intervention which, in the majority of cases, will only be dietary-behavioral», Giussani continues.
Cardiovascular screening: when and why to start. “From the age of 5, it is advisable to measure blood pressure annually for all children. If blood pressure, weight, height and BMI parameters are normal, a specific cardiac screening is not necessary. In case of overweight or hypertension, however, More in-depth tests are recommended, such as echocardiography and blood tests (blood sugar, cholesterol, triglycerides)”, specifies Sip. Even in children of normal weight, but with a family predisposition for cardiovascular diseases, it is important to carry out screening that includes the same tests. “Family history can double the risk of cardiovascular disease, so it is essential to conduct an updated family history, including second-degree relatives”, concludes Bona.
Interview Between Time.news Editor and Dr. Marco Giussani, Pediatric Cardiologist
Editor: Welcome, Dr. Giussani! We’re grateful to have you here to discuss an urgent and critical topic: childhood cardiovascular diseases. Recent findings from the Italian Society of Paediatrics highlight the need for early prevention, starting from a young age. Can you elaborate on why childhood is such a crucial period for cardiovascular health?
Dr. Giussani: Thank you for having me! Absolutely. Cardiovascular diseases often have their roots in childhood, which is why early detection and prevention are essential. Research shows that risk factors such as dyslipidemia can start to manifest in children as young as 8-10 years. If we catch these issues early, we can implement lifestyle changes that may drastically reduce the risks later in life.
Editor: That’s alarming but also enlightening. You mentioned dyslipidemia and hypertension as key risk factors. How prevalent are these issues among children today?
Dr. Giussani: Indeed, it’s concerning. Studies indicate that arterial hypertension affects about 4-5% of the pediatric population, but this can rise to 20-25% in certain high-risk groups. These figures are non-negligible, especially considering that many children may not show symptoms. This ‘silent’ presence of risk factors makes regular screenings so crucial.
Editor: What strategies can parents adopt to help protect their children from these risks?
Dr. Giussani: The Italian Society of Paediatrics has outlined five important tips for preventing cardiovascular diseases in children. First, we need to promote healthy lifestyles with balanced diets and regular physical activity. Second, monitoring blood pressure should start at age five. For children who are overweight or have hypertension, in-depth assessments are advised.
Editor: Those are practical steps. Can you tell us more about family history and its impact on assessing risks?
Dr. Giussani: Certainly! It’s vital for parents to assess and be aware of their family history regarding cardiovascular diseases, diabetes, and dyslipidemia. If there’s a history of these conditions, children should undergo further evaluations. Early interventions can significantly alter the trajectory toward developing cardiovascular diseases.
Editor: You touched upon obesity being a growing concern among children. Could you define what you mean by a “metabolic pandemic”?
Dr. Giussani: Yes, the term refers to the alarming rise in obesity rates among children and adolescents worldwide. This trend is often accompanied by metabolic disorders, which further increase the risk of cardiovascular diseases. When we talk about “pandemic,” we’re recognizing that this is not just a localized issue but a widespread public health crisis requiring immediate attention and action.
Editor: It’s quite a daunting picture you paint, but what do you envision as the future of pediatric cardiovascular health? Can we turn the tide on these issues?
Dr. Giussani: I’m optimistic! By raising awareness, implementing systematic screening, and fostering healthier habits from an early age, we can certainly make strides toward improving pediatric cardiovascular health. Governments, schools, and healthcare systems must work together to create environments that promote health and well-being for all children.
Editor: Thank you for your insightful perspectives, Dr. Giussani. As we conclude, what message would you like to leave our readers regarding their role in preventing cardiovascular diseases in children?
Dr. Giussani: Parents play a pivotal role in shaping their children’s health. Encourage healthy eating habits, engage in physical activities, and don’t hesitate to consult healthcare professionals for regular check-ups. Awareness and preventive measures can make all the difference. Together, we can safeguard the future health of our children.
Editor: Thank you again for your valuable insights, Dr. Giussani. Let’s hope for a healthier generation ahead!
