Cardiovascular Risk in Young Persons: Secondary or Primordial Prevention?

Editorials3 August 2010Cardiovascular Risk in Young Persons: Secondary or Primordial Prevention?Gerald S. Berenson and Sathanur R. SrinivasanGerald S. BerensonFrom The Tulane Center for Cardiovascular Health, New Orleans, LA 70112, and Tulane University Health Sciences Center, New Orleans, LA 70112. and Sathanur R. SrinivasanFrom The Tulane Center for Cardiovascular Health, New Orleans, LA 70112, and Tulane University Health Sciences Center, New Orleans, LA 70112.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-3-201008030-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this issue, Pletcher and colleagues (1) study the risk factor burden of serum low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides associated with coronary artery calcification detected by electron-beam computed tomography. They use valuable observations collected over 20 years from the CARDIA (Coronary Artery Risk Development in Young Adults) study.The risk factor burden of LDL cholesterol, HDL cholesterol, and triglycerides was estimated as a cumulative exposure by time average of nonoptimal levels, as defined by the National Cholesterol Educational Program (NCEP) (2). The NCEP recommendations serve as targets for the general population in the United States. ...References1. Pletcher MJ, Bibbins-Domingo K, Liu K, Sidney S, Lin F, Vittinghoff E, et al. Nonoptimal lipids commonly present in young adults and coronary calcium later in life: the CARDIA (Coronary Artery Risk Development in Young Adults) study. Ann Intern Med. 2010;153:137-46. LinkGoogle Scholar2. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001;285:2486-97. PMID: 11368702 CrossrefMedlineGoogle Scholar3. Berenson GS, Wattigney WA, Tracy RE, Newman WP, Srinivasan SR, Webber LS, et al. Atherosclerosis of the aorta and coronary arteries and cardiovascular risk factors in persons aged 6 to 30 years and studied at necropsy (The Bogalusa Heart Study). Am J Cardiol. 1992;70:851-8. PMID: 1529936 CrossrefMedlineGoogle Scholar4. Gidding SS, McMahan CA, McGill HC, Colangelo LA, Schreiner PJ, Williams OD, et al. Prediction of coronary artery calcium in young adults using the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) risk score: the CARDIA study. Arch Intern Med. 2006;166:2341-7. PMID: 17130387 CrossrefMedlineGoogle Scholar5. Mahoney LT, Burns TL, Stanford W, Thompson BH, Witt JD, Rost CA, et al. Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. J Am Coll Cardiol. 1996;27:277-84. PMID: 8557894 CrossrefMedlineGoogle Scholar6. Porkka KV, Viikari JS, Taimela S, Dahl M, Akerblom HK. Tracking and predictiveness of serum lipid and lipoprotein measurements in childhood: a 12-year follow-up. The Cardiovascular Risk in Young Finns study. Am J Epidemiol. 1994;140:1096-110. PMID: 7998592 CrossrefMedlineGoogle Scholar7. Doherty TM, Tang W, Detrano RC. Racial differences in the significance of coronary calcium in asymptomatic black and white subjects with coronary risk factors. J Am Coll Cardiol. 1999;34:787-94. PMID: 10483961 CrossrefMedlineGoogle Scholar8. Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med. 2008;358:1336-45. PMID: 18367736 CrossrefMedlineGoogle Scholar9. Broyles S, Katzmarzyk PT, Srinivasan SR, Chen W, Bouchard C, Freedman DS, et al. The pediatric obesity epidemic continues unabated in Bogalusa, Louisiana. Pediatrics. 2010;125:900-5. PMID: 20368311 CrossrefMedlineGoogle Scholar10. Rose G. Sick individuals and sick populations. Int J Epidemiol. 1985;14:32-8. PMID: 3872850 CrossrefMedlineGoogle Scholar11. Labarthe DR, Dai S, Day RS, Fulton JE, Grunbaum JA; Project HeartBeat! Writing Group. Findings from Project HeartBeat! Their importance for CVD prevention. Am J Prev Med. 2009;37:S105-15. PMID: 19524150 CrossrefMedlineGoogle Scholar12. Berenson GS, Harsha DW, Johnson CC, Nicklas TA. Teach families to be heart smart. Patient Care. 1993;6:134-5. Google Scholar13. Downey AM, Greenberg JS, Virgilio SJ, Berenson GS. Health promotion model for "Heart Smart": the medical school, university, and community. Health Values. 1989;13:31-46. PMID: 10296776 MedlineGoogle Scholar14. Berenson GS; Bogalusa Heart Study Group. Primordial Prevention—A Perspective from the Bogalusa Heart Study. The University of Pittsburgh Online Supercourse. 2009. Accessed at www.pitt.edu/~super1/lecture/lec36561/index.htm on 2 July 2010. Google Scholar15. Berenson GS. Cardiovascular risk begins in childhood: a time for action Editorial. Am J Prev Med. 2009;37:S1-2. PMID: 19524149 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Gerald S. Berenson; Sathanur R. SrinivasanAffiliations: From The Tulane Center for Cardiovascular Health, New Orleans, LA 70112, and Tulane University Health Sciences Center, New Orleans, LA 70112.Acknowledgment: The authors thank the children and families who made the Bogalusa Heart Study possible.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-1343.Corresponding Author: Gerald S. Berenson, MD, 1440 Canal Street, New Orleans, LA 70112; e-mail, berenson@tulane.edu.Current Author Addresses: Drs. Berenson and Srinivasan: 1440 Canal Street, New Orleans, LA 70112. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNonoptimal Lipids Commonly Present in Young Adults and Coronary Calcium Later in Life: The CARDIA (Coronary Artery Risk Development in Young Adults) Study Mark J. Pletcher , Kirsten Bibbins-Domingo , Kiang Liu , Steve Sidney , Feng Lin , Eric Vittinghoff , and Stephen B. Hulley Metrics Cited byOxidative Stress and Cardiovascular Risk and Prevention in Children and AdolescentsAssociation Between the NFKB1 -94ins/del ATTG Polymorphism (rs28362491) and Coronary Artery Disease: A Systematic Review and Meta-AnalysisAtherogenic Dyslipidemia and Cardiovascular Risk Factors in Obese ChildrenCardiovascular Prevention: Components, Levels, Early Origins, and MetricsCardiovascular Disease Risk in Children and AdolescentsCholesterol ester transfer protein (CETP) gene polymorphism and selected parameters of lipid metabolism in children from families with history of cardiovascular system diseasesAdolescence Risk Factors Are Predictive of Coronary Artery Calcification at Middle AgeEthnic Differences in Carotid Intima-Media Thickness Between UK Children of Black African-Caribbean and White European Origin 3 August 2010Volume 153, Issue 3Page: 202-203KeywordsChildrenCholesterolCoronary arteriesCoronary heart diseaseLongitudinal studiesMedical risk factorsObesityStable coronary artery disease ePublished: 3 August 2010 Issue Published: 3 August 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...