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Children and Heart Disease: What's Wrong With This Picture?

As more children become obese, pediatric heart disease is becoming more common.
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WebMD Magazine - Feature

Few parents expect their children to develop heart disease. So when her daughter Alex started gaining weight at age 7, Tammy Benton was concerned -- but not overly concerned. Working with a pediatrician, she tried to encourage Alex to eat more healthfully.

"I didn't talk 'diet' to her," recalls Benton, 46, of Essexville, Mich. Instead, she pointed her daughter to better choices such as fruit instead of candy. Alex did lose some weight but eventually gained it back. By the time she was 14, she weighed 320 pounds. This time, Benton and her daughter had a serious discussion with their pediatrician, who referred them to heart specialists.

Benton, who takes cholesterol-lowering medications, was worried not only about Alex's weight but also with how her own history of high cholesterol would affect both her daughters. Alex, now 19, and Benton's other daughter, Sidney, now 17, have had high cholesterol since they were 8 years old. By age 12, Alex needed medication to lower her cholesterol.

Even so, Benton wasn't prepared for what the heart doctors had to say. "They talked about Alex's increased risk factors [for heart disease] and her chances of heart attack and stroke." And they weren't referring to her future risk as an adult -- but to her immediate risk. "Keep in mind Alex was 14 years old. When they start talking to you about your child having a heart attack or stroke, it's horrifying," she says.

The Childhood Obesity Epidemic

Like Benton, most parents are surprised at the gravity of the risks associated with childhood obesity -- and that the risks are immediate, not down the road in adulthood, says Thomas Kimball, MD, a pediatric cardiologist at Cincinnati Children's Hospital Medical Center and professor of pediatrics at the University of Cincinnati College of Medicine.

But unfortunately, the statistics tell the sober truth: Childhood obesity has skyrocketed in the past three decades, according to the CDC. Stats for 1976–1980 show that 6.5% of children ages 6 to 11 were obese; by 2003-2006, that number had jumped to 17%. Similarly, only 5% of preteens and teens ages 12 to 19 were obese in 1976–1980; but 17.6% of this age group were found to be obese in 2003-2006. ("Obese" is defined as having a body mass index above the 95th percentile compared with other children of the same age and gender.)

Obesity, in turn, is triggering a host of other heart disease risk factors in children, such as type 2 diabetes, high blood pressure, and high cholesterol -- considered "adult" health problems until recently. The result? A higher risk of heart disease and stroke at young ages, Kimball says. "We're seeing changes in heart structure and artery structure [in kids] that we normally don't see until well into adulthood," Kimball says.

The cholesterol problem among children and teens has gotten so bad that some doctors are prescribing cholesterol-lowering statins (such as Lipitor) for children, although the practice is controversial. "It's still pretty rare, but it is happening," Kimball says.

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