Doctors should start screening teenagers for heart disease risks



I didn’t have a heart attack last year because I had one stressful morning at work, or ate one piece of bacon. In fact, at Mayo Clinic, we learned that most cardiovascular disease is actually 20-30 years in the making. So why are we waiting decades for cardiac symptoms to become severe enough to be noticed?

About one third of young people ages 10-19  in North America have LDL (bad) cholesterol levels that are too high (considered by many to be a risk factor for developing heart disease).  In some cases, high cholesterol runs in families. This is called familial hypercholesterolemia. About 1% to 2% of children have this condition, and they should have their cholesterol levels checked before they are 5 years old.

When the bodies of young soldiers (many just in their teens) who died in the Korean and Vietnam wars were autopsied, most had coronary arteries that were already showing signs of dangerous plaque deposits. Several studies have shown that fatty plaque buildup begins in children as young as 10, and progresses slowly into adulthood. This disease process is called atherosclerosis, which leads directly to heart disease. 

Over 4,000 teenagers in North America start smoking everyday. In fact, most people who smoke started before they finished high school. This means that if children can stay smoke-free in school, they will probably never smoke.  Thousands of people die each year from heart diseases caused by smoking. Among young people who would otherwise have a very low risk of heart disease, cigarette smoking may be the direct cause of as many as 75% of diagnosed heart disease cases.  And, the longer a person smokes, the higher the risk of heart disease. The combination of smoking and taking birth control pills has also been linked to increased risks of heart disease – a combination seen in young women at alarming rates.

Researches say that between 16% and 33% of children and teenagers are obese. As a result, there has been a sharp rise in obesity-related problems like type 2 diabetes (usually seen only in adults) which is a serious risk factor for heart disease.

Active children usually grow up to be active adults. Aside from preventing heart disease risk factors later in life, regular exercise will:

  • help control weight
  • strengthen bones
  • lead to better bone development and will lower the risk of thin or brittle bones (osteoporosis) in adulthood
  • increase self-esteem and self-confidence
  • improve cardiovascular health by lowering blood pressure, increase the amount of HDL or “good cholesterol” in the blood, and reduce stress levels

If your child is physically inactive, the first thing you can do is develop some backbone and limit the amount of time spent watching TV, playing video games, or surfing the Internet. Look into organized sports, lessons, or clubs that suit your child’s interests. Most importantly, spend time with your child, and create family outings that involve some type of physical activity (e.g. biking, walking, hiking). Exercise is important for all children, even those who do not like sports, have little coordination, or have a disability. By focusing on active ‘play’ instead of exercise, children will most likely change their exercise behaviors and increase their physical activity on their own.

A report in the journal Circulation this month outlines a new treatment document suggesting that our doctors should begin assessing cardiovascular risk factors for all patients beginning at age 18, with an emphasis on improving lifestyle factors that include diet, smoking, drinking, and physical activity.

Concerned about your teenager’s heart health?  Share your opinion below. 

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