For a Healthy Heart, Get an Early Start

Here is a little quiz for anyone with a heart:

At what age can a child first show signs of heart disease?

a.) 18
b.) 13
c.) 8
d.) 3

If you said "d," raise a glass of low-fat milk and go to the head of the class; heart disease can start at a surprisingly young age.

"Kids look so healthy that you don't really think about whether they have risk factors for cardiovascular disease later in life," says Dr. Christine L. Williams, director of the Children's Cardiovascular Health Center at Columbia University in New York City.

"But it's a process that begins very early in childhood. You can begin to see fatty streaks in the aorta as early as 3 years of age," she says. "The battle's often lost in the first few years, and it can be very hard to undo the damage."

Coronary Heart Disease - The Number One Killer 

Coronary heart disease is the number one killer in the United States, causing about 525,000 deaths a year.

Williams and other pediatric heart specialists think they can cut that number by stressing healthy lifestyles early in childhood.

New AHA Guidelines Published

So, the American Heart Association (AHA) recently published new guidelines for physicians that emphasize education and information on healthy heart habits for young patients and their families.

Among the recommendations:

• Get a family history of heart disease and stroke when the child is still a newborn.
  

• Between the ages of 2 and 6, begin cholesterol screening for children whose parents have high cholesterol.
  

• Start checking the child's blood pressure at age 3.
  

• Encourage active physical play and discourage sedentary behavior.

"By kindergarten, it's nice to know which children have a tendency to be on the high-risk side," says Williams, who chaired the committee that developed the guidelines. "With a lot of them, all you might have to do is switch them to low-fat dairy products."

Dr. Hugh Allen, physician-in-chief at Columbus Children's Hospital in Ohio, says the American Heart Association hopes to duplicate the success of the anti-smoking campaign that began in the 1960s and cut the rate of smoking in half over the next 30 years.

"Very much, I would like to see the same kind of response," he says. "You might think of this as an immunization. If we know there are environmental factors associated with the disease, and we can develop lifestyle changes that will affect it later in life, that is certainly an effective approach."

Heart-Healthy Living Begins At Home and In School

For children, those lifestyle changes must begin at home and in school, both physicians say.

"The obese kid usually sits at the table with an obese family," Allen says.

Williams agrees: "The whole family's got to get involved. This is really a whole-family issue."

Schools should play their part, Allen says, by offering healthy meals in the cafeteria and cutting out the high-fat junk food that many now make available. And regular physical education, which has fallen victim to cutbacks over the past 20 years, needs to make a comeback.

"The sad thing is, I saw a couple of obese kids this morning, and they only have gym once a week at school," Williams says.

More physicians also need to make education a regular part of their routine—something Allen says many are already doing.

"I know a lot of family practitioners try to work preventative information into their office material," he says. "Some do a better job than others, but everybody does have some opportunity. We can whittle away at it every day."

If Allen had his way, he says, there would be a tax of at least $5 on every pack of cigarettes. Schools would serve only healthy food.

"And I would encourage physical activity as a reward, not as a duty," he says. "Let's not use food as a reward, let's use physical activity as a reward: 'Good job on your homework -- now you can go out and play.'"

Always consult your child's physician for more information.

October 2002

Coronary Heart Disease - The Number One Killer 

New AHA Guidelines Published

Heart-Healthy Living Begins At Home and In School

Hormone May Signal Heart Trouble in Teens 

Online Resources

Hormone May Signal Heart Trouble in Teens 

Adolescents with high levels of leptin show early signs of cardiovascular disease 

Healthy teenagers who have high levels of leptin, a hormone linked to obesity, already show the first signs of stiffening in their blood vessel walls.

That is the disturbing conclusion of a study published in a recent issue of Circulation, Journal of the American Heart Association.

The loss of elasticity in artery walls is an early sign of cardiovascular disease. This study offers insight into the role of leptin in development of early cardiovascular disease and indicates a physiological connection between obesity and vascular disease, the study authors say.

The study included 294 healthy adolescents, aged 13 to 16, with a range of body mass indexes. Ultrasound tests were used to examine the teenagers' arteries, and they were measured for blood pressure, blood cholesterol, glucose, leptin, and the inflammation marker C-reactive protein (CRP).

The researchers found a connection between elevated leptin levels and arterial impairment, regardless of other factors. A 10 percent increase in leptin concentration was associated with a 1.3 percent decrease in arterial elasticity.

Leptin is made by fat cells and regulates appetite and metabolism. Obese people have high leptin levels. Decreased elasticity in blood vessels means a heavier workload for the heart. In healthy people, artery walls contract and expand as blood is pumped through them.

When arteries become stiff, they do not dilate fully, and that causes reduced blood flow and greater exertion for the heart.

Always consult your adolescent's physician for more information.

Online Resources

American Academy of Pediatrics (AAP)

American Heart Association

Circulation, Journal of the American Heart Association