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Articles On Cardiovascular Disease

Cardiovascular disease. Only in populations with lifelong hypocholesterolemia is a near absence of clinical coronary heart disease (CHD) observed. As with blood pressure, lipid levels track through childhood. Autopsy studies have consistently demonstrated the adolescent onset of the atherosclerotic process, and the Bogalusa Heart Study has confirmed the strong association between antemortem cholesterol levels and postmortem atherosclerosis in adolescents and young adults.

 

The prevention of cardiovascular disease in adulthood begins with the diagnosis and treatment of dyslipidemia in childhood and adolescence. After brief reviews of the prevalence and causes of dyslipidemia, this chapter focuses on the recommendations for screening and an evidence-based approach to the management of dyslipidemia in adolescents.

Common dyslipidemias are often associated with other conditions, such as type 2 diabetes, obesity, alcoholism, hypothyroidism, pregnancy, renal failure, or drug use, and hence are termed secondary. Secondary dyslipidemias often have a strong genetic component, since some exacerbating conditions are frequently but not universally associated, suggesting that subjects who develop secondary dyslipidemia might have a subtle inherited metabolic defect that confers susceptibility. For example, abdominal obesity, metabolic syndrome and type 2 diabetes have important effects on lipoprotein metabolism, and both these traits are highly heritable. It is important to distinguish between primary and secondary dyslipidemias, since this may determine the preferred means of intervention. some conditions associated with secondary dyslipidemias.

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