Cardiovascular disease may be rare in kids, but risk factors present in childhood can increase the chances that a child will develop heart disease as an adult.
Because of these risks, new guidelines released online on Monday, November 14in the journal Pediatrics will give health care providers a “road map” to address all the major cardiovascular risk factors as part of regular well-child visits.
So what has changed?
Previous recommendations, issued in 1992, called for screening only children with a family history of heart disease or high cholesterol.
These new recommendations call for all children to be screened for high cholesterol at least once between the ages of 9 and 11 years, and again between ages 17 and 21 years.
Physicians now will be able to use a non-HDL cholesterol test that does not require children to fast; children with abnormal results should be followed up with a fasting lipid profile..
The new guidelines suggest ways to prevent the development of cardiovascular risk factors and optimize cardiovascular health starting from the beginning by encouraging breast feeding.
The guidelines recommend a diet low in saturated fat starting at a child’s first birthday. Protection from tobacco smoke as well as regular physical activity will also be advised by pediatricians and other care providers.
“The more we learn about heart disease and stroke in adults, the more we know that the process begins in childhood and progresses over time,” said Stephen R. Daniels, MD, PhD, FAAP, chair of the expert panel that reviewed the guidelines. “By working with families, we can keep kids at a lower lifetime risk and prevent more serious problems in adulthood.”
It is anticipated that a universal screening will more accurately identify children who are at high risk of cardiovascular disease and allow pediatricians to follow up, Dr. Daniels said.
Most children with high cholesterol would be referred to lifestyle modifications including diet and physical activity; for children with high blood pressure, the DASH diet is recommended.
The guidelines also identify age-specific strategies to reduce risk factors and manage cardiovascular disease in children and adolescents.
Packing a lunch from home and limiting screen time are ways to help prevent children from putting on too much weight. Cutting down on salt and increasing fiber in the diet are others.