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Review
. 2015 Nov 5:36:9.
doi: 10.1186/s40985-015-0011-2. eCollection 2015.

Screening for cardiovascular disease risk factors beginning in childhood

Clemens Bloetzer  1 , Pascal Bovet  2 , Joan-Carles Suris  1   2 , Umberto Simeoni  1 , Gilles Paradis  3 , Arnaud Chiolero  2   3
Affiliations
Review

Screening for cardiovascular disease risk factors beginning in childhood

Clemens Bloetzer et al. Public Health Rev. .

Abstract

Cardiovascular diseases (CVD) are the leading cause of death worldwide. Individual detection and intervention on CVD risk factors and behaviors throughout childhood and adolescence has been advocated as a strategy to reduce CVD risk in adulthood. The U.S. National Heart, Lung, and Blood Institute (NHLBI) has recently recommended universal screening of several risk factors in children and adolescents, at odds with several recommendations of the U.S. Services Task Force and of the U.K. National Screening committee. In the current review, we discuss the goals of screening for CVD risk factors (elevated blood pressure, abnormal blood lipids, diabetes) and behaviors (smoking) in children and appraise critically various screening recommendations. Our review suggests that there is no compelling evidence to recommend universal screening for elevated blood pressure, abnormal blood lipids, abnormal blood glucose, or smoking in children and adolescents. Targeted screening of these risk factors could be useful but specific screening strategies have to be evaluated. Research is needed to identify target populations, screening frequency, intervention, and follow-up. Meanwhile, efforts should rather focus on the primordial prevention of CVD risk factors and at maintaining a lifelong ideal cardiovascular health through environmental, policy, and educational approaches.

Keywords: Adolescents; Cardiovascular disease; Children; Screening.

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Figures

Fig. 1
Fig. 1
Blood pressure would be an ideal risk marker for screening if the distribution of blood pressure in individuals having a cardiovascular disease (CVD) was very different than in individuals not having a CVD (a). However, blood pressure is a relatively weak risk factor for CVD (i.e., elevated blood pressure is a poor discriminator for sorting out individuals who will have a CVD form other individuals) as there is no large difference in the distribution of blood pressure between individuals having CVD and individuals not having a CVD (b) [14, 38]. The same is true for blood lipids
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