Heart Disease Risk Factors for Children and Teenagers
David Cohen, M.D.·Published 1 December 2011·10 min read
Key points
Heart disease is not a major cause of death among children and teenagers, but it is the largest cause of death among adults in the United States.
Again, some of these risk factors can be changed, treated, or modified, and some cannot.
Fewer than 3% of children in the United States have high blood pressure.
The heart pumps blood through a network of arteries, veins, and capillaries.
Heart disease is not a major cause of death among children and teenagers, but it is the largest cause of death among adults in the United States. In fact, someone in America dies every 37 seconds from some form of cardiovascular disease.
Thanks to many studies and thousands of patients, researchers have found certain factors that play an important role in a person's chances of developing heart disease. These are called risk factors. Some risk factors can be changed, treated, or modified, and some cannot.
Most of the risk factors that affect children can be controlled early in life, lowering the risk of heart disease later in life. Other risk factors are usually passed down through family members (they are hereditary) or they are the result of another illness or disease. These risk factors usually can be controlled. Congenital heart disease (heart defects you are born with) cannot be changed, but better tests and treatments are now available for children with these types of heart problems.
Children and teens can lower their risk of getting heart disease by changing or controlling the risk factors that can lead to heart disease later in life.
Children and teens can lower their risk of getting heart disease by changing or controlling the risk factors that can lead to heart disease later in life.
High blood pressure High cholesterol Smoking Obesity Physical inactivity
Again, some of these risk factors can be changed, treated, or modified, and some cannot. But it is important to understand that prevention is the best way to avoid a heart problem later in life. Controlling as many risk factors as possible, starting in childhood, will help reduce your child's risk of developing heart disease as an adult.
High Blood Pressure
Fewer than 3% of children in the United States have high blood pressure. But high blood pressure is a serious condition in childhood, especially if it is not detected. It is wise to make sure that your child's blood pressure is checked at his or her yearly check-up.
What is high blood pressure?
The heart pumps blood through a network of arteries, veins, and capillaries. The moving blood pushes against the walls of the arteries, and this force is measured as blood pressure.
High blood pressure results from the tightening of very small arteries called arterioles. Arterioles regulate the blood flow through the body. As these arterioles tighten (or constrict), the heart has to work harder to pump blood through the smaller space, and the pressure inside the vessels grows.
What causes high blood pressure in children?
Written and revised by
David Cohen, M.D.
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High blood pressure (hypertension) in children is not a congenital heart disease, but it can have a hereditary link. For that reason, children born into families with a history of high blood pressure need to have their blood pressure watched with special care.
Most cases of high blood pressure in children are usually the result of another disease, like heart or kidney disease. This is called secondary hypertension. Less often, children have what is called primary (or essential) hypertension. This means that the real cause of the high blood pressure is not known.
High blood pressure in children
If your child is under 10 years old and has high blood pressure then this is likely to have been caused by one of the factors mentioned above.
But if they are aged 10 and above then they may have developed this for other reasons which include:
Overweight/obese Poor diet (too much fat and salt) Lack of exercise
As you can see, these are the same 'lifestyle factors' which cause high blood pressure in adults. Yes, some children can develop high blood pressure for exactly the same reasons as an adult.
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High blood pressure in teenagers If your teenager has high blood pressure then this may be caused by lifestyle factors such as those mentioned above. It is still unusual for a teenager to develop high blood pressure although this is starting to change with the rise in obesity.
Obesity levels are increasing in young people which pre-dispose them towards all types of health problems. This includes high blood pressure.
Untreated high blood pressure can lead to serious medical conditions later on in life such as heart disease, stroke and kidney failure. But it can be controlled via medication and a healthy lifestyle which means that the young person can lead a normal life.
How is blood pressure measured?
The doctor will measure your child's blood pressure using a device called a sphygmomanometer.
Blood pressure readings measure the two parts of blood pressure: systolic and diastolic pressures. Systolic pressure is the force of blood flow through an artery when the heart beats. Diastolic pressure is the force of blood flow within blood vessels when the heart rests between beats.
A blood pressure reading measures both the systolic and diastolic forces, with the systolic pressure listed first. The numbers show the pressure in units of millimeters of mercury (mm Hg)-how high the pressure inside the arteries would be able to raise a column of mercury.
Symptoms of high blood pressure in young people
Children, like adults do not experience any symptoms of high blood pressure but some may display the following:
Severe cases of high blood pressure can cause nosebleeds, heart palpitations, dizziness and nausea.
If your child shows any of these symptoms then seek medical advice as soon as possible.
It is a good idea to have your child's blood pressure checked on a regular basis especially if they have an underlying condition or are overweight or obese.
Blood pressure is measured using two numbers -an upper number or 'systolic pressure' and a lower number or 'diastolic'.
But normal blood pressure readings in children and teenagers vary according to age, sex and height. In this sense they differ from the readings used for adults.
The doctor will look at your child's age, sex, and height to determine the age-, sex-, and height-specific systolic and diastolic blood pressures. Doctors use this method because it lets them look at different levels of growth to determine blood pressure. It also lets them get the most accurate classification of blood pressure according to your child's body size.
How is high blood pressure in children treated?
In most cases, lifestyle changes will help children control their high blood pressure.
Help your child maintain a healthy body weight. Children who are overweight usually have higher blood pressure than those who are not. Increase their physical activity. Limit how much salt they eat. Warn them about the dangers of cigarette smoking. The nicotine in cigarettes causes the blood vessels to narrow, making it even harder for blood to flow through the vessels.
If a program of diet and exercise does not lower your child's blood pressure, medicines may be prescribed.
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Cholesterol
Less than 15% of children have high cholesterol levels, but studies have shown that fatty plaque buildup begins in childhood and progresses slowly into adulthood. This disease process is called atherosclerosis. In time, atherosclerosis leads to heart disease, which is the single biggest cause of death in the United States.
What is cholesterol?
Cholesterol is a fat-like substance called a lipid that is found in all body cells. The liver makes all of the cholesterol your body needs to form cell membranes and to make certain hormones. Extra cholesterol enters the body when you eat foods that come from animals, like meats, eggs, and dairy products.
Although we often blame the cholesterol found in foods that we eat for raising blood cholesterol, the main culprit is the saturated fat in our food. Foods rich in saturated fat include butter fat in milk products, fat from red meat, and tropical oils such as coconut oil.
Cholesterol travels to cells through the bloodstream in special carriers called lipoproteins. Two of the most important lipoproteins are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Doctors look at how LDL, HDL, and fats called triglycerides relate to each other and to your total cholesterol level.
Low-density Lipoprotein
LDL particles deliver cholesterol to the body's cells. LDL cholesterol is often called "bad cholesterol" because high levels are thought to lead to heart disease and diseases of the blood vessels. Too much LDL in the blood causes fatty plaque to form on artery walls, which starts the disease process atherosclerosis. When plaque builds up in the coronary arteries that supply blood to the heart, there is a greater risk of having a heart attack.
LDL levels may be high if you eat a diet with a lot of saturated fat, cholesterol, or both. Sometimes, an underactive thyroid (called hypothyroidism) may also increase LDL levels.
High-density Lipoprotein
HDL particles carry cholesterol from the body's cells back to the liver, where it can be removed from the body. HDL is known as "good cholesterol" because high levels are thought to lower the risk of heart disease. Low HDL is often the result of physical inactivity, obesity, or smoking.
Triglycerides
High Cholesterol Levels in Teens
Healthy cholesterol levels do not vary between teen boys and girls. Your son's doctor takes three cholesterol types into consideration. His LDL, or bad cholesterol, contributes to plaque buildup, and should be low. His HDL, or good cholesterol, helps clear excess LDL from his blood, and should be high. Your son's total cholesterol measures all cholesterol in his blood, both good and bad. Your teen is at risk for heart disease if his LDL is 130 mg/dL or greater, his HDL is 35 mg/dL or less and his total is 200 mg/dL or more, according to Children's Hospital Boston. These levels pertain to children between the ages of 2 and 19.
The Balancing Act
Teen boys between the ages of 11 and 14 require approximately 2,500 calories per day, while boys between 15 and 18 require 2,800 calories. Knowing this is crucial, as you base your son's diet on his daily caloric intake. MassGeneral Hospital for Children explains saturated fats should not comprise more than 10 percent of your teen's daily calories. Examples of saturated fats include red meat, vegetable oil, butter, sour cream and cream cheese. No more than 10 percent of calories should come from healthy polyunsaturated fats such as walnuts, salad dressings, mayonnaise, sunflower or flaxseeds, and corn or sunflower oil. Limit his intake of cholesterol to 300 mg per day and increase his intake of fresh fruits and vegetables. If necessary, seek nutritional counseling to ensure you meet your son's nutritional needs while adjusting his diet to lower his cholesterol.
Triglycerides are fats that provide energy for the muscles. Like cholesterol, they are delivered to the body's cells by lipoproteins in the blood. Eating foods with a lot of saturated fat or carbohydrates will raise triglyceride levels. Elevated levels are thought to lead to a greater risk of heart disease, but scientists do not agree that high triglycerides alone are a risk factor for heart disease.
What causes high cholesterol in children and teenagers?
In some cases, high cholesterol runs in families. This is called familial hypercholesterolemia. About 1% to 2% of children have this condition, and they should have their cholesterol levels checked before they are 5 years old.
Other risk factors for high cholesterol include obesity, high blood pressure, and smoking. Unless your child has any of these risk factors, most children and teenagers do not need to have their cholesterol levels checked until age 20.
How is high cholesterol prevented or treated?
To reduce the risk of fatty buildup in the arteries, your child should
Get plenty of exercise. Encourage them to exercise 30 to 60 minutes on most days of the week. Texas Heart Institute Heart Information Center. Have your child eat more breads, pasta, cereals, and fresh fruits and vegetables. (Note: You should not restrict how much fat children eat if they are younger than two years old. Infants need fat for growth and development. After the age of two, children should start to eat fewer calories from fat.) Know the dangers of cigarette smoking. Learn to control weight, diabetes, or high blood pressure, if the child has any of these conditions.
Children who have been diagnosed with high cholesterol will need to at least follow a special program of diet and exercise. If 1 year of diet and exercise therapy does not lower their cholesterol, cholesterol-lowering medicines may be prescribed. Children who have high cholesterol and other risk factors for heart disease may also need to take these medicines.
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