New Risk Factor for Adult Heart Disease Identified in Children

CINCINNATI‑Physicians have identified a risk factor for heart disease in adulthood that can be present in children as young as age 10.

They’re also calling for screening for this risk factor to help motivate children to exercise and lose weight.

The researchers from Cincinnati Children’s Hospital Medical Center found an association between stiffness of arteries and function of the heart’s left ventricle later in life. The study, conducted in more than 600 preteens and young adults, will be presented Oct. 1 at the American Academy of Pediatrics annual meeting in San Francisco.

"Screening for arterial stiffness and diastolic function – the ability of the left ventricle to relax and fill with blood before contracting and pumping it to the body – may be called for in obese teens or those with type II diabetes if we want to identify young people at increased risk for developing early cardiac disease,” says Tom Kimball, MD, a pediatric cardiologist at Cincinnati Children’s, senior author of the study and a professor of pediatrics at the University of Cincinnati (UC) College of Medicine.

Kimball and his colleagues in the Heart Institute at Cincinnati Children’s obtained echocardiograms, arterial stiffness measurements and other data on 612 individuals 10 to 24 years old.

Those with arterial stiffness who were older, heavier, had a poorer lipid profile and higher blood sugar also had poorer left ventricular diastolic function, a known risk factor for heart disease.

Arterial stiffness is measured using a variety of non-invasive tests, including ultrasound and pulse transducers, which measure an artery's ability to expand and contract as the heart pulses and relaxes.

The researchers hypothesize that arterial stiffness raises blood pressure, which causes thicker hearts, which leads to diastolic dysfunction. Those in this study with arterial stiffness had higher blood pressure.

Previous studies have linked hypertension to thicker hearts and diastolic dysfunction. The study is the latest in a series of studies conducted by Kimball and colleagues at Cincinnati Children’s that have been presented or published in recent years, all leading to the conclusion that there are risk factors in childhood that predict heart disease in adults.

In 2001, two studies showed for the first time that obesity in children directly affects structure and function of the heart, which could lead to increased risk for heart disease.

A 2003 study suggested that certain abnormalities of the heart are more common in obese children than in children of normal weight. A 2004 study showed that morbid obesity in children and adolescents directly affects the structure of their hearts and puts them at increased risk for future heart attack.

More recently, Kimball identified BMI rebound age as a risk factor: The earlier in young childhood that kids reach their lowest BMI and then begin to gain body mass, the greater the chance of having adverse changes in known cardiovascular risk factors, which can show up as early as age 7.

"Health care professionals shouldn’t accept current trends in childhood BMI and left ventricular mass when determining if children are healthy and have normal hearts,” says Kimball.

"Pediatricians and family physicians must start measuring children’s BMI as early as age 3 and help families reverse it if required.”