This consensus document highlights the urgent need for comprehensive cardiovascular prevention strategies starting in childhood to effectively reduce the future global burden of cardiovascular diseases.
Cardiovascular and cerebrovascular diseases (CVDs), primarily driven by atherosclerosis, remain the leading cause of mortality worldwide and represent a major healthcare burden. Mounting evidence demonstrates that atherosclerotic processes begin in childhood, with lipid streaks detectable as early as the first decade of life. The increasing prevalence of obesity, hypertension, dyslipidemia, insulin resistance, and other modifiable cardiovascular risk factors (CVRFs) in children and adolescents highlights the urgent need for prevention strategies starting early in life. This document, jointly produced by the Italian Society of Pediatrics (SIP), the Italian Society of Hypertension (SIIA), the Italian Society for the Study of Atherosclerosis (SISA), and the Italian Society for Cardiovascular Prevention (SIPREC), emphasizes that atherosclerosis should be considered a disease with its roots in childhood and that true primary prevention must begin from pregnancy and birth. Two possible and complementary levels of intervention should be considered: (1) populationwide promotion of healthy diets, lifestyles, and supportive environments; and (2) early identification and management of specific CVRFs in children and adolescents. The involvement of multiple stakeholders—families, pediatricians, schools, healthcare professionals, policymakers, patient associations, and the media—is crucial to ensure the effectiveness of prevention interventions. Particular attention must be given to obesity, as both an independent risk factor and a driver of additional metabolic and vascular risks. Fighting CVDs requires a paradigm shift: preventive action must start early, be comprehensive, and mobilize all sectors of society. Only by addressing cardiovascular risk during childhood can the future burden of CVDs be effectively reduced. Received: 15 October 2025 / Accepted: 26 November 2025 / Published online: 9 December 2025 © The Author(s) 2025 Cardiovascular Prevention in Children, Adolescents, and Young Adults. A Call-to-Action of the Italian Societies of Pediatrics (SIP), Hypertension (SIIA), Study of Atherosclerosis (SISA), and Cardiovascular Prevention (SIPREC) Simonetta Genovesi1,2 · Roberto Volpe3 · Davide Agnoletti4 · Simonetta Bellone5 · Gianni Bona5 · Manuela Casula6,7 · Luigi Gentile8 · Francesca Saladini9 · Rino Agostiniani10 · Agostino Virdis11 · Alberico L. Catapano6,7 · Massimo Volpe12,13 · Marco Giussani2 Online ISSN 1179-1985 S. Genovesi et al. 1 Introduction Cardiovascular and cerebrovascular diseases (CVDs) are the main causes of death worldwide, and recognize atherosclerosis as their common denominator 1. It is therefore clear that the prevention of CVDs based on atherosclerosis should be at the forefront of any action aimed at reducing mortality, disability and health expenditure in our country 2, 3. The vascular alterations that characterize atherosclerosis begin very early and may already be present in the first decade of life. The speed at which this process develops is proportional to the presence of risk factors, that are already present in childhood and adolescence. In this context, the risk of an increase in CVDs in the coming years is becoming a major social and health problem, particularly in view of the epidemic of obesity (OB) affecting children and adolescents. Overweight (OW) and OB are escalating globally, in part due to poor nutrition, unhealthy dietary practices and inadequate early life interventions. The OB epidemic seems an unstoppable trend threatening the cardiovascular (CV) and, generally, health and life expectancy also of our children 4. This issue represents a major and complex challenge. However, a growing body of evidence and experience is indicating new solutions that could work. Unhealthy diets and lifestyles are key factors in the development of obesity and cardiovascular risk factors (CVRFs). Therefore, targeted interventions to reduce excess weight and correct unhealthy lifestyles and eating habits from childhood onwards are fundamental to preventing CV disease in adulthood 5. Therefore, it is mandatory to act to ensure healthier diets and lifestyles for children and adolescents. True primary prevention should begin as early as possible— ideally from pregnancy 6 and birth, in order to counteract the various epigenetic influences that, throughout the course Graphical Abstract new
genovesi et al. (Tue,) studied this question.