Why heart disease is not an age old problem

The epidemic of childhood obesity is paving the way for a significant increase in heart disease

The epidemic of childhood obesity is paving the way for a significant increase in heart disease

THE ARTERIES of many obese children and teenagers are as thick and stiff as those of 45 year olds. This is a sign that such children could have severe cardiovascular disease at a much younger age than their parents unless their condition is reversed, researchers have said.

"It's possible that they will have heart disease in their 20s and 30s," says Dr Geetha Raghuveer of the University of Missouri at Kansas City, who led the study presented at a New Orleans meeting of the American Heart Association.

"There's a saying that 'you're as old as your arteries', meaning that the state of your arteries is more important than your actual age in the evolution of heart disease and stroke," she says.

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"We found that the state of the arteries of these children is more typical of a 45 year old than of someone their own age."

Experts did not find the result surprising, but did view it as "alarming".

"We're facing an epidemic of childhood obesity," says Dr Michael Schloss, co-director of the lipid treatment programme at the New York University School of Medicine, who was not involved in the study. "We are raising a generation of children that are going to have a significant increase in vascular disease as they get older."

A May study from the Centers for Disease Control and Prevention found that 16.3 per cent of US children and teenagers are obese, and a separate 15.6 per cent are overweight.

Raghuveer runs a preventive cardiology clinic for children who have high cholesterol levels, obesity and a family history of cardiac deaths.

She and her colleagues used ultrasound imaging to measure the thickness of the inner walls of the carotid arteries in 70 children considered at risk.

The children all had abnormalities in one or more types of cholesterol, and 40 of them had a body mass index, or BMI - a calculation of weight and height routinely used as a measure of obesity - in the 95th percentile.

Because the researchers did not have access to healthy children for comparison, they compared the measured values to readily available data for 45 year olds, using an arbitrary cut-off value of the 25th percentile, Raghuveer says.

They found that three-quarters of the children had artery thickness above this level.

The artery thickening was most advanced in patients who were the most obese, and had the highest levels of a type of cholesterol known as triglycerides, so that combination "should be a red flag to the doctor that a child is at high risk of heart disease", she says.

Their long-term prospects "are not good" unless they can reverse the condition.

The findings suggest the potential for "a major public health problem" down the road, says Dr Albert Bove of the Temple University School of Medicine, president-elect of the American College of Cardiology, who was not involved in the study.

"If we begin to see people disabled in their 30s and 40s because of heart disease, we could lose a significant fraction of the workforce. They will also require a large amount of health care, so costs will go up significantly."

But there is some hope.

"If we can identify the condition early and start modifying triglycerides, we can probably prevent progression and perhaps even promote regression," says Dr John Kennedy, director of prevention cardiology at Marina del Rey Hospital, in Los Angeles.- ( Los Angeles Times/ Washington Post)