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December 3, 1997

Prevention of Coronary Artery Disease Is a Pediatric Problem

JAMA. 1997;278(21):1779-1780. doi:10.1001/jama.1997.03550210077044

The report by Bao et al1 underscores the importance of primary prevention of coronary artery disease (CAD) beginning in childhood. Specifically, their findings suggest that the most effective strategy for prevention of CAD in adulthood may be prevention of obesity in childhood. Data from the Bogalusa Heart Study show consistently increased incidence of overweight children whose parents have early CAD. These individuals were identified as being overweight in childhood and developed an adverse cardiovascular risk profile in adulthood that was predictive of premature CAD. Data from the National Health and Nutrition Examination Survey III (NHANES III) compared with previous NHANES data document an increasing obesity epidemic in this country, especially in children.2 Given the universally acknowledged failure of most weight-loss treatment programs, obese children are likely to become obese adults, thereby increasing their risks of hypertension, diabetes, hyperlipidemia, and chronic diseases, including coronary heart disease.3 On a