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Heart Disease Begins in Childhood
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Damage is done long before chest pains hit

Most people don't think much about warding off heart disease until middle age, but by then much of the damage is already done. New research shows that even children can suffer the beginnings of a build-up of plaque that can eventually cause a heart attack.

"The message is that when someone has a heart attack at 40 or 50 or 60, it is generally the end of several decades of plaque formation," says Dr. E. Murat Tuzcu, director of the Intravascular Ultrasound Laboratory at the Cleveland Clinic Foundation in Cleveland, Ohio.

"We are not telling people to run to their pediatricians and take their children for screening. What we are asking is that parents encourage children to eat more balanced diets and make sure they are getting enough physical activity."

Tuzcu and his colleagues studied the heart arteries of 181 transplant recipients two to six weeks following the procedure. The transplanted hearts were taken from donors ages 13 to 55 who died in car accidents or from gunshot wounds -- not from disease.

Using ultrasound, the researchers found that one in six hearts from teen-age donors -- or about 17 percent -- had significant blockages, or plaque, in at least one coronary artery feeding blood to the heart.

"This doesn't mean that those teen-agers are ready to have a heart attack," says Tuzcu, lead author of the study presented at a recent American Heart Association meeting. "The process starts at a very early age, probably even earlier than the teen years, and progresses over the decades."

Age increased the likelihood of plaque formation: 37 percent of donors ages 20 to 29; 60 percent of donors ages 30 to 39; 71 percent of donors ages 40 to 49; and 85 percent of donors over age 50 had significant blockages, according to the study.

Watch that cholesterol!

Atherosclerosis occurs when fatty substances, such as cholesterol, or other materials are deposited along the inner lining of an artery. The deposits can lead to blockages that restrict the flow of blood in the arteries and can cause a heart attack.

Evidence of early atherosclerosis was previously found in autopsies of American soldiers killed in the Korean War, but this is the first study to take a close look into living hearts of apparently disease-free young people. The researchers used sound waves to create an image of the heart arteries by placing a miniature ultrasound device on a tube and guiding it to the heart through an artery in the transplant patient's leg.

Lack of exercise, smoking, high cholesterol, high blood pressure, obesity and diabetes can contribute to heart disease, says Dr. Lynn Mahony, chair of the American Heart Association's Council on Cardiovascular Disease and the Young.

Children as young as five should be eating a "heart-healthy" diet, which means limiting fat, salt and cholesterol, Mahony says. And parents should encourage their kids to be physically active by limiting television, video and Internet usage and by telling them go outside and play. Or they should make sure they're involved in after-school sports.

"What you learn when you're young is often what you do as an adult," Mahony says.

Kids: Get out and exercise

But there are disturbing signs children aren't getting the exercise they should. The percentage of children taking part in daily physical activity has declined from 45 percent in 1991 to 25 percent today, according to a recent U.S. Surgeon General report.

And obesity among children has been climbing steadily for years. About 11 percent of children are considered obese, up from only about 5 percent in the early '70s, according to the Centers for Disease Control and Prevention.

"The epidemic of obesity in the United States and the declining popularity of physical education, poor eating habits and increases in the rate of smoking in teen-agers, [these] all work to sow the seed of disease which becomes apparent in middle age," Tuzcu says.

The number of teens between the ages of 12 and 17 who started smoking increased by 30 percent between 1988 and 1996, according to American Heart Association statistics.

What To Do

Even if family history is working against you, lowering other risk factors might very well save your life -- no matter what your age.

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