The lack of physical activity and diet that is poor in nutrients and rich in saturated fat can promote a true epidemic of high cholesterol (dyslipidemia) in childhood and adolescence. Observational data from the NHANES study (The National Health and Nutrition Examination Survey) estimated a 7.8% incidence of increased total cholesterol in children and adolescents aged between 8 and 17 years. In this analysis, approximately one in five children and adolescents aged 8-17 years had some lipid change (total cholesterol, HDL-C or non-HDL-C).
The Brazilian study ERICA (Study of cardiovascular risks in adolescents) evaluated data from Brazilian youth aged between 12 and 17 years. Lipid changes were defined as LDL-C ≥ 100 mg / dL, HDL-C <45 mg / dL and triglycerides (TG) ≥ 100 mg / dL. Out of a total of 38,069 included adolescents, more than 24,000 had at least one abnormal lipid profile value (64.7%) and 3.7% had changes in the three parameters. The most common combination of lipid diseases was the presence of high triglycerides and low HDL-C. As expected, the higher the body mass index for adolescents, the greater the incidence of combined lipid disorders.
LDL is responsible for the formation of fatty plaques – in the arteries, inhibits blood flow and increases the risk of heart attack and stroke. HDL, on the other hand, prevents cardiovascular disease (CVDs) by reducing plaque accumulation. The country’s population consists of 70 million children and young people, representing 33% of Brazilians.
Obesity, high blood pressure, physical inactivity and smoking are among the risk factors for the installation of atherosclerotic disease – which is the accumulation of cholesterol plaque on the walls of the arteries. It causes obstruction of the blood flow and creates an ideal scenario for cardiovascular disease. The development of cardiovascular risk factors and metabolic diseases in childhood results in a loss of cardiovascular health in adulthood, along with weight gain and obesity.
And the number of overweight people between the ages of 2 and 19 has increased over the last four decades: North American data over the past decade indicate that 17% of individuals in this age group are obese and 15% are overweight. Young people with obesity have significantly lower lipid profiles (higher total cholesterol, LDL-c and triglycerides and lower HDL-c), higher blood pressure (BP), glucose and insulin concentrations than their non-obese peers.
“If before, dyslipidemia in children was mainly due to genetic causes such as familial hypercholesterolemia (which is a genetic change characterized by an increase in cholesterol at the expense of LDL-c, in addition to being the most common and associated with a high risk of cardiovascular events in adults). ), deterioration of diet, sedentary lifestyle and increasing obesity at this stage of life, are crucial factors for the increase in metabolic risk, characterized by high triglyceride levels and low HDL-c “, says cardiologist Ana. Paula Marte Chacra, who will give a lecture on atherosclerosis in children and adolescents at the 42nd Congress of Cardiology at SOCESP, which takes place on 16, 17 and 18 June at the Transamerica Expo Center, in São Paulo. “This is an extremely relevant issue because we have seen a significant increase in the case of dyslipidemia in pediatric clinics. “
The concern with the theme is justified: a study conducted by the North American Studies Center Bogalusa heart examination showed that about 50% of children with abnormal lipid values perpetuate the abnormality in adulthood. “Most dyslipidemias start in childhood or adolescence and therefore it is important to identify them followed by early treatment to reduce future cardiovascular risks in these individuals.”
According to the cardiologist, it is first and foremost important to identify severe dyslipidemias that require the use of drugs. “A recent study has shown that statins, taken when needed since childhood, were associated with a reduction in the progression of atherosclerosis in children with familial hypercholesterolemia,” says Ana Paula. But in the vast majority of cases – whether it is with high cholesterol or high triglycerides in this age group – it is possible to regulate the indices through healthy lifestyle habits, including diet and physical activity. “It is the cheapest, most effective and without contraindications medicine to really suffocate the disease in the bud.”
42nd Congress of Cardiology in SOCESP
Date of the event: June 16-18, 2022
Place: Transamerica Expo Center, Sao Paulo / SP