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October 1986

Can (Should) the Pediatrician Wage Preventive Medicine War Against Coronary Heart Disease?

Author Affiliations

Texas Children's Hospital 6621 Fannin Houston, TX 77030

Am J Dis Child. 1986;140(10):985-986. doi:10.1001/archpedi.1986.02140240031018

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Before responding to this question, there are four often-quoted statements that need repetition. They are three scientifically proved facts and one conclusion from deductive reasoning pertinent to children concerning acquired atherosclerotic coronary heart disease:

  1. Atherosclerotic cardiovascular disease heads the list of the nation's killer diseases in adults, including people still in their active, working, productive years.

  2. Scientifically controlled clinical investigations in adult patients with fully developed atherosclerotic heart disease show a reduction in mortality and morbidity simply by eliminating or reducing some existing risk factors.

  3. Atherosclerosis begins sometime in childhood, dysmorphologically if not dysfunctionally.

  4. By deductive reasoning, if pediatricians start risk-factor modification early in childhood, atherosclerosis can be minimized, slowed, or perhaps prevented entirely.

Why do pediatricians, traditionally experts in preventive medicine, omit coronary heart disease from their planned preventive programs? One Houston pediatrician estimates that as much as 90% of his professional time is spent

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