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- Neal Halfon, MD, MPH*
- Philip A. Verhoef, MD, PhD†
- Alice A. Kuo, MD, PhD‡
- *University of California Los Angeles Center for Healthier Children, Families, and Communities, Los Angeles, CA.
- †Section of Pulmonary and Critical Care, Department of Medicine, Section of Critical Care, Department of Pediatrics, University of Chicago, Chicago, IL.
- ‡University of California Los Angeles Combined Internal Medicine and Pediatrics Residency Program, Los Angeles, CA.
Author Disclosure
Drs Halfon, Verhoef, and Kuo have disclosed no financial relationships relevant to this article. This commentary does contain a discussion of an unapproved/investigative use of a commercial product/device.
- CVD:
- cardiovascular disease
- DM:
- diabetes mellitus
- IDF:
- International Diabetes Federation
- LCHD:
- Life Course Health Development
- NCEP:
- National Cholesterol Education Program
Educational Gap
New recommendations for blood pressure and lipid screening were issued by the American Academy of Pediatrics in November, 2011, and are addressed in this article.
Objectives
After completing this article, readers should be able to:
Understand the Life Course Health Development framework for examining the impact that childhood factors have on adult health.
Understand cardiovascular disease and the risk factors for its development, including pediatric criteria for the metabolic syndrome.
Understand the consequences of poor nutritional habits and obesity in childhood and adolescence.
Know the risk factors for hypertension and hypercholesterolemia, as well as how to evaluate and treat both conditions.
Screen for, diagnose, and treat type 2 diabetes mellitus.
Introduction
Many of the most common and costly chronic adult health conditions have their origins in childhood and adolescence. This recognition is leading to both a profound shift in our understanding about the developmental origins of diseases, such as hypertension, dyslipidemia, and type 2 diabetes mellitus (DM), and a greater focus on how different risk and protective factors influence the developmental pathways that determine optimal health across the life span. Scientific breakthroughs in the basic, clinical, and epidemiological sciences reveal how different stressors and exposures during what are now termed “critical” or “sensitive” periods of development can affect growth, tissue differentiation, and physiologic set points that influence an individual's response to metabolic, physiologic, emotional, and environmental challenges throughout life. In light of this explosion of new scientific data about the importance of the early years for lifelong health and development, general pediatricians will have to play an increasing role in addressing childhood antecedents to adult cardiovascular diseases (CVDs).
A growing body of …
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