- The American Heart Association (AHA) has released a scientific statement on risk reduction in children who have cardiovascular (CV) disease risk.
- The publication includes an algorithm and a comprehensive listing of relevant guidelines.
Why this matters
- Statement is for primary care clinicians, specialists, and subspecialists and focuses on management.
- Children are grouped based on risk:
- High risk includes history of diabetes, end-stage renal disease, stem cell therapy, transplant.
- Moderate risk includes history of hypertension, severe obesity, familial hypercholesterolemia.
- At risk includes history of insulin resistance, chronic inflammatory disease, cardiotoxic chemotherapy.
- Algorithm starts with tiers based on risks; step 1 is to identify risk tier.
- Step 2 is to consider all cardiovascular disease factors that are present; having 2+ elevates patient to next tier.
- Step 3 is to use algorithm cut points (e.g., BMI, cholesterol, BP thresholds) to determine needed lifestyle changes (step 4) and/or drug therapies (step 5).
- In general:
- High risk: management should be therapeutic lifestyle changes and management of the specific disease.
- Moderate or at risk: therapeutic lifestyle change is first step, then consider medication.
- Statement also offers a comprehensive table of resources for clinicians and patients, including guidelines for specific situations (e.g., severe obesity, chronic kidney disease).