Vascular health in children and adolescents: effects of obesity and diabetes

Abstract

The foundations for cardiovascular disease in adults are laid in childhood and accelerated by the presence of comorbid conditions, such as obesity, diabetes, hypertension, and dyslipidemia. Early detection of vascular dysfunction is an important clinical objective to identify those at risk for subsequent cardiovascular morbidity and events, and to initiate behavioral and medical interventions to reduce risk. Typically, cardiovascular screening is recommended for young adults, especially in people with a family history of cardiovascular conditions. Children and adolescents were once considered to be at low risk, but with the growing health concerns related to sedentary lifestyle, poor diet and obesity, cardiovascular screening may be needed earlier so that interventions to improve cardiovascular health can be initiated. This review describes comorbid conditions that increase cardiovascular risk in youth, namely obesity and diabetes, and describes noninvasive methods to objectively detect vascular disease and quantify vascular function and structure through measurements of endothelial function, arterial compliance, and intima-media thickness. Additionally, current strategies directed toward prevention of vascular disease in these populations, including exercise, dietary interventions and pharmacological therapy are described.

Keywords:

• endothelial function
• arterial compliance
• intimal medial thickness
• inflammation
• intervention

Acknowledgements

KRS is supported by research funding from the Oklahoma Center for the Advancement of Science and Technology (HR07-156S) and Grant Number P20RR024215 from the National Center for Research Resources. AWG is supported by grants from the National Institute on Aging (R01-AG-24296), National Center on Minority Health and Health Disparities (P20-MD-000528), National Center for Research Resources (M01-RR-14467 and P20-RR-024215), and Oklahoma Center for the Advancement of Science and Technology (HR09-035). KCC is supported by research funding from the National Institutes of Health (U01-DK061230-09). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health. The authors report no conflicts of interest in this work.