Obesity is a driving factor for increased CVD risk among adolescents

American Diabetes Association 68th Scientific Sessions

Treating children early to prevent cardiovascular risk factors, specifically obesity, may help to reduce the onset of cardiovascular disease in adulthood, according to results of the Bogalusa Heart Study.

“Some cardiovascular risk factors are modifiable, such as diet and exercise, but some we can’t change like genetics and gender,” said Elaine M. Urbina, MD, director of preventative cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Oh. “These do result in abnormal cardiovascular function and structure and may result in CVD later in life.”

Urbina presented findings from the study yesterday at the American Diabetes Association 68th Scientific Sessions, held in San Francisco.

The Bogalusa Heart Study is a mixed, cross-sectional, longitudinal study of cardiovascular risk factors among a biracial population of over 14,000 children (two-thirds white) in Bogalusa, New Orleans. It began in 1972 and will receive funding through 2011. The researchers examined the early, natural history of coronary artery disease and hypertension in pediatric participants and associated risk factors.

Findings from the study have shown that lifestyle behaviors that increase a person’s risk for CVD are learned in childhood and that abnormal levels of cardiovascular risk factors can be identified in children.

“These levels are different from adults; they change with rapid growth, but they are useful in predicting adult risk factors,” she said. “We also found that these risk factors correlate directly with how they are managed and the precursors of adult CVD and metabolic syndrome can be found in childhood.”

Participants with greater than 35% body fat had double the risk of development of hypertension as a young adult. Similarly, obesity was associated with an increased incidence of dyslipidemia in adolescence, according to Urbina, and baseline adiposity increased the risk of hyperinsulinemia. Findings also showed that obesity in childhood is one of the major risk factors that predicted cardiac enlargement, vascular stiffness and cardiac dilation in adulthood.

As a result of these findings, the researchers and colleagues at the Center for Cardiovascular Health, Tulane, developed the Health Ahead Heart Smart Education Program as an outreach of the data collected from the study. This is a comprehensive program targeted to teach children the necessary educational tools such as risk, diet, exercise and provide them with essential information to potentially prevent cardiovascular risk factors in adulthood, according to Urbina.

“We should remind patients that it is a lot easier to fit in an hour of exercise than to deal with the risk that may come later,” she said. “Measuring risk factors in youth is important; we really can make a difference if we treat risk factors early.” – by Tara Grassia

The Bogalusa study is among the most important pediatric studies related to CVD. It’s really the pediatric Framingham study and provides us with the most evidence that we have about the risk of development of CVD in pediatric patients, and evidence about how we can be effective about reducing the risk. It is a phenomenally important study and has also allowed us to look at differences among ethnic groups, primarily at differences predominantly comparing African Americans and caucasians, which is extremely useful.

– Stephen R. Daniels, MD, PhD

Professor and Chairman, Department of Pediatrics, University of Colorado School of Medicine

For more information:

Berenson G. Bogalusa Heart Study – Development of cardiovascular disease in children and adolescents.

Daniels SR. Cardiovascular disease risk factors in pediatrics.

Both presented at: American Diabetes Association 68th Scientific Sessions; June 6-10, 2008; San Francisco