Maybe it’s time to bring Junior in for a heart check-up.
Heart attacks are vanishingly rare in kids and adolescents, but a growing body of literature suggests that the seeds of heart problems later in life are sewn in this age group. Two studies published recently in Circulation lend further credence to this idea.
In the first of these, Markus Juonala and colleagues at Finland’s Turku University Hospital followed a cohort of 4,380 people from a very young age through their 40s, and found that high systolic blood pressure, high cholesterol levels and a high body mass index in—get this—kids as young as age 9 are strong predictors of arterial wall thickening more than 3 decades later. This thickening is good non-invasive evidence of arteriosclerosis, the proximate cause of heart attacks and strokes.
Interestingly, Juonala’s group found that the presence of these risk factors at either age 3 or age 6 did not have a similar predictive value for problems later in life.
The second study, by Mika Kähönen and colleagues of Tampere University Hospital (also in Finland) used a similar longitudinal design. This group essentially proved that what your mother has been telling you all these years is correct: kids who ate fruits and vegetables at least once per day turned out to have healthier arteries when they became young adults than those who consumed these heart healthy foods twice a month or less.
Both studies relied on an arterial pulse wave velocity test to assess arterial wall thickening.
The results of these studies support many earlier ones which have indicated that all those well-established cardiac risk factors start kicking-in between the ages of 8 and 10. And yes, they do suggest it might not be a bad idea to get Junior checked for cardiac risk factors about the time he enters 4th grade.
The visit might include a blood pressure check, a cholesterol test, an assessment of the body mass index and a careful history covering exercise, diet and exposure to second-hand cigarette smoke. That said, it’s essential to seek guidance on the meaning of this visit from your doctor, since norms for these tests and historical factors aren’t as well established for kids as they are for adults.