Hyperlipidemia and Cardiovascular Risk in Children and Adolescents

Abstract

Atherosclerotic cardiovascular disease (ASCVD) represents the major cause of morbidity and mortality worldwide. The onset of the atherosclerosis process occurs during childhood and adolescence, subsequently leading to the onset of cardiovascular disease as young adults. Several cardiovascular risk factors can be identified in children and adolescents; however, hyperlipidemia, in conjunction with the global obesity epidemic, has emerged as the most prevalent, playing a key role in the development of ASCVD. Therefore, screening for hyperlipidemia is strongly recommended to detect high-risk children presenting with these disorders, as these patients deserve more intensive investigation and intervention. Treatment should be initiated as early as possible in order to reduce the risk of future ASCVD. In this review, we will discuss lipid metabolism and hyperlipidemia, focusing on correlations with cardiovascular risk and screening and therapeutic management to reduce or almost completely avoid the development of ASCVD.

Keywords: adolescents; atherosclerosis; atherosclerotic cardiovascular disease; cardiovascular risk; children; dyslipidemia; hyperlipidemia; lipid metabolism.

Figure 1

Exogenous pathway of lipid metabolism. Triglycerides (TG), lipoprotein lipase (LPL), microsomal triglyceride transfer protein (MTTP).

Figure 2

Endogenous pathway of lipid metabolism. Very-low-density lipoprotein (VLDL), low-density lipoprotein (LDL), high-density lipoprotein (HDL), intermediate-density lipoprotein (IDL), lipoprotein lipase (LPL), microsomal triglyceride transfer protein (MTTP), cholesteryl ester (CE).