Documented changes occur by 5 to 8 years of age. Cardiovascular risk factors can be identified in early life. The levels of risk factors in childhood are different than those in the adult years. Levels change with growth phases, i.e. in the first year of life, during puberty and adolescence, and in the transition to young adulthood. Autopsy studies show lesions in the aorta, coronary vessels, and kidney relate strongly to clinical cardiovascular risk factors, clearly indicating atherosclerosis and hypertension begin in early life.
Environmental factors are significant and influence dyslipidemia, hypertension, and obesity.
Those that are controllable include diet, exercise, and cigarette smoking. Lifestyles and behaviors that influence cardiovascular risk are learned and begin early in life. Healthy lifestyles should be adopted in childhood, because they are critical to modulation of risk factors later in life. Primary care physicians and pediatricians can play a major leadership role in the prevention of adult heart diseases beginning in childhood. Physicians are encouraged to obtain risk factor profiles on children, along with a family history of heart disease.