Early onset of cardiovascular disorders in children: risk factors and long-term consequences

Cardiovascular diseases (CVD), including myocardial infarction and stroke, remain the leading cause of morbidity and mortality in industrialized nations. This review highlights studies demonstrating that adverse prenatal factors play a significant role in determining cardiovascular health and contribute to the early development of subclinical atherosclerosis in children and adolescents. Indirect evidence of early atherosclerosis in children can be obtained through non-invasive imaging of vascular changes, such as anatomical alterations (e.g., increased intima-media thickness), mechanical changes (e.g., increased arterial stiffness), and physiological changes (e.g., reduced flow-mediated dilation). Effective early identification of individuals, particularly children, at an increased risk of future cardiovascular diseases is critical for prevention. Existing algorithms for assessing CVD risk or stages primarily rely on “traditional” risk factors. However, these algorithms often fail to accurately detect atherosclerosis in young individuals and are unsuitable for pediatric use, emphasizing the need for alternative methods to classify risk in asymptomatic young patients. This article provides an overview of such methodologies.