Prevention of heart disease beginning in childhood through comprehensive school health: the heart smart program
1993
Berenson, G.S.
Cardiovascular diseases (CVDs) are the major cause of morbidity and death in the United States today. In industrialized, developed populations atherosclerotic, coronary artery disease (CAD) involves in excess of 70% of the adult population, whereas hypertension affects 20% of the adult white population and over 40% of the adult black population. The importance of clinical CVD risk factors in adults as an aid to the prediction of heart disease has evolved from results of the Framingham Study (20) and many other epidemiologic studies; more recently, interest has been focused on risk factors in children and young adults. Research over the past 20 years has established that both atherosclerosis and essential hypertension clearly begin in childhood (1). A number of epidemiologic studies of large populations of children have now contributed significantly to the understanding of the early development of CVD risk factors and elucidation of the early natural history of CAD. Observations of large populations of children show that hyperlipidemia develops from childhood into young adulthood; major excess of obesity exists and has an impact on CVD risk; evidence of anatomic cardiovascular changes with high blood pressure levels are noted; and evidence of aberrations in carbohydrate metabolism that may contribute to diabetes later in life are present (2).
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