Many Teenagers Have at Least 1 CVD Risk Factor

Many Teenagers Have at Least 1 CVD Risk Factor

Elizabeth DeVita-Raeburn

May 21, 2012 — Thirty-seven percent of normal-weight adolescents had at least 1 risk factor for cardiovascular disease (CVD), as did 49% of those who were overweight and 61% of those who were obese, according to a study published onlineMay 21 in Pediatrics.

Ashleigh L. May, PhD, an epidemic intelligence service officer in the Division of Heart Disease and Stroke Prevention at the US Centers for Disease Control and Prevention, and colleagues analyzed data on 3383 adolescents between the ages of 12 and 19 years who participated in the National Health and Nutrition Examination Survey, a cross-sectional, stratified, multistage probability sample survey of the US population done between 1999 and 2008.

Among all the adolescents in the study, the overall prevalence of risk factors was 14% for prehypertension or hypertension, 22% for borderline-high or high low-density lipoprotein (LDL) cholesterol, 6% for low high-density lipoprotein (HDL) cholesterol, and 15% for prediabetes or diabetes.

The prevalence of prediabetes and diabetes increased from 9% to 21% between 1999 and 2008. Obesity did not increase during the span of the study, possibly because of increased awareness of the problem in the general population, the authors note.

When the researchers stratified the sample population by body mass index (BMI), they found that a “consistent dose-response increase in the prevalence of each of these CVD risk factors was observed by weight categories,” they report.

Overweight and obese adolescents were more likely to have 2 risk factors than normal-weight youths, and obese adolescents were more likely to have 3 or more risk factors than their normal-weight peers.

The most common combination of risk factors in obese and overweight adolescents was prehypertension or hypertension and borderline-high or high LDL cholesterol.

Adolescents were categorized as obese if they were in the 95th percentile or higher for BMI and overweight if they fell between the 85th and 95th percentiles. Normal-weight adolescents fell between the 5th and 85th percentiles. Those below the 5th percentile were not included in the study.

CVD risk factors are often present during childhood and adolescence, but the “overt manifestations,” of these risk factors, such as heart attack and stroke, do not usually emerge until adulthood, the authors write.

“Adolescence represents a window of opportunity for assessment of CVD risk factors and the promotion of lifestyles that will affect the development and progression of CVD,” the authors write.

Information on family history, exercise, diet, and smoking behaviors was not included in the analysis because it was not available in the data used for the study. Other limitations included the fact that measures other than BMI, such as waist circumference or waist-to-height ratio, may be better predictors of CVD risk factors than BMI in children and adolescents.

Finally, the scarcity of studies similar to National Health and Nutrition Examination Survey makes it difficult to compare the results of this study with previous research. “This highlights the need for initiating surveillance of CVD risk factors among adolescents,” the authors conclude.

The authors have disclosed no relevant financial relationships.

Pediatrics. Published online May 21, 2012. Abstract

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