Preventing Heart Risks at the Root


Preventing Heart Risks at the Root - Two studies published Monday suggest that the road to hypertension and heart disease starts in childhood and that prevention should start there, too.

One analysis found that parental smoking increases the risk for high blood pressure in preschoolers, and the other that excessive sugar consumption in teenagers is associated with multiple factors known to increase the risk for cardiovascular disease. Both reports appear in the journal Circulation.


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The first study looked at 4,236 children in Germany, where 5-year-olds undergo a compulsory physical and cognitive assessment before starting school. During the period of the study, 2007-8, more than 28 percent had at least one parent who smoked. Even after correcting for body mass index and parental hypertension, having a smoker as a parent substantially increased the likelihood that a child would have blood pressure readings in the top 15 percent of the sample.

Parental smoking was not the only association, or even the strongest. Being overweight and having a parent with hypertension were also associated with high blood pressure in the children. But the lead author, Dr. Giacomo D. Simonetti, said smoking was probably the easiest risk to modify.

Dr. Simonetti, a professor of pediatrics at the University of Bern in Switzerland, said there was little risk for cardiovascular disease in children. But high blood pressure persists into adulthood, and then becomes a major contributor to heart disease risk.

“If you have a kid who has high blood pressure, it’s likely he will continue to have high blood pressure,” he said. “It’s the same for B.M.I. — for an obese child, the chance of remaining obese as an adult is very high.”

The authors acknowledge that it would take a long-term study to provide proof a smoke-free childhood promotes cardiac health in adulthood. But secondhand smoke has no benefits for children and many well-known risks. There is good reason to believe that adult hypertension is one of them.

The second report was based on a nationwide sample of 2,157 adolescents surveyed by the Centers for Disease Control and Prevention using a questionnaire that assessed dietary intake.

Teenagers, the researchers found, eat large quantities of sugar. In this study, the daily consumption of added sugars — that is, sugar added to foods and beverages during processing or preparation — averaged 476 calories a day per child, the equivalent of more than half a cup of table sugar. Sugar made up more than one-fifth of their total energy intake.

The researchers found that teenagers who consumed the largest amounts of sugar — more than 30 percent of their calories in that form — were significantly more likely to have lower HDL (high-density lipoproteins, or “good” cholesterol), higher LDL (low-density lipoproteins, or “bad” cholesterol) and higher triglyceride blood levels than those who ate the least, about 10 percent of their total calories.

All three of these factors are known risks for heart disease. The association held after controlling for socioeconomic factors and sex, and for the consumption of fats, carbohydrates, protein and cholesterol.

“I think that parents should be aware of how of much their teenagers’ daily energy comes from added sugars,” said the lead author of the study, Jean A. Welsh, a postdoctoral fellow at Emory University. “It’s a nutrient that provides energy but contributes very little else. Sugar-sweetened beverages are a major contributor, and there may be negative health consequences down the line.”

She cautioned that this was an observational study, and that more research, particularly in the form of prospective studies, would be needed to firmly establish the connection.

Dr. Simonetti and Dr. Welsh agreed that childhood was not too soon to be thinking about the risk for heart disease. “We always speak about prevention of cardiovascular disease in adults,” Dr. Simonetti said. “But the prevention of these diseases begins in childhood.” ( nytimes.com )


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