High Prevalence of Dyslipidemia in Children and Adolescents: Opportunity for Prevention

Cardiovacular diseases are a major cause of morbidity and mortality. According with the World Health Organization (WHO), worldwide, one third of ischemic heart diseases are attributable to high cholesterol, which causes 2.6 million deaths per year. Atherosclerosis begins in childhood and evolves in an insidious process which can last decades from the first artery injuries to the clinical outcomes (death, myocardial infarction or strokes). This process is speeded up by risk factors such as cholesterol, smoking, obesity and hypertension.

The multicenter study Pathological Determinants of Atherosclerosis in Youth (PDAY) revealed the presence of atherosclerosis injuries in all aortas and in 50% of right coronary arteries in 1.532 necropsies of individuals aged from 15 to 19 years. When the role of risk factors was assessed in individuals between 15 and 34 years of age, it was found that the aortic injuries were positively correlated with LDL and VLDL levels, glucose intolerance, smoking, hypertension, obesity, but negatively associated with HDL levels. Similar findings were described by the Bogalusa Heart Study, which associated the presence of fatty streaks in the aorta with higher total and LDL cholesterol levels, in addition to an inverse association with HDL-C. There was also greater severity of atherosclerosis injuries in the presence of multiple concomitant risk factors (body mass index, blood pressure, cholesterol and triglyceride concentration).

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