Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics.
Although for most children the process of atherosclerosis is subclinical, dramatically accelerated atherosclerosis occurs in some pediatric disease states, with clinical coronary events occurring in childhood and very early adult life. As with most scientific statements about children and the future risk for cardiovascular disease, there are no randomized trials documenting the effects of risk reduction on hard clinical outcomes. A growing body of literature, however, identifies the importance of premature cardiovascular disease in the course of certain pediatric diagnoses and addresses the response to risk factor reduction. For this scientific statement, a panel of experts reviewed what is known about very premature cardiovascular disease in 8 high-risk pediatric diagnoses and, from the science base, developed practical recommendations for management of cardiovascular risk.
Kavey
Rae-Ellen W
RE
National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, USA.
Allada
Vivek
V
Daniels
Stephen R
SR
Hayman
Laura L
LL
McCrindle
Brian W
BW
Newburger
Jane W
JW
Parekh
Rulan S
RS
Steinberger
Julia
J
D001172:Arthritis, Rheumatoid / Q000150:complications; D050197:Atherosclerosis / Q000209:etiology; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D002908:Chronic Disease; D048909:Diabetes Complications / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D019317:Evidence-Based Medicine; D006330:Heart Defects, Congenital / Q000150:complications; D016027:Heart Transplantation; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D007674:Kidney Diseases / Q000150:complications / Q000628:therapy; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications; D009369:Neoplasms / Q000150:complications; D012307:Risk Factors; D040242:Risk Reduction Behavior