Genovesi Simonetta, Giussani Marco, Orlando Antonina, Battaglino Maria Grazia, Nava Elisa, Parati Gianfranco
School of Medicine and Surgery, University Milano-Bicocca, Milan, Italy.
Department of Cardiovascular, Neural, and Metabolic Sciences, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Milan, Italy.
High Blood Press Cardiovasc Prev. 2019 Jun;26(3):191-197. doi: 10.1007/s40292-019-00316-6. Epub 2019 Apr 30.
The atherosclerotic alterations that are the basis of cardiovascular diseases can start already in childhood. For this reason the prevention of cardiovascular diseases should be undertaken very early both in the general population and, in a targeted manner, in subjects at cardiovascular risk. Preventive strategies should include measures to encourage physical activity and correct eating habits and to reduce exposure to pollutants. The main actors responsible for carrying out these preventive interventions are the local and national political authorities. Moreover, particular attention should be paid to the first thousand days of life starting from conception, to prevent unfavorable epigenetic modifications. In addition to initiatives aimed at the general population, interventions should be planned by the medical community to assess the individual risk profile. The current obesity epidemic has in fact made it relatively frequent even among children and adolescents to find some cardiovascular risk factors known in adults such as arterial hypertension, dyslipidemia, glucose metabolism disorders and increased of uric acid values. The purpose of this review is to indicate lines of intervention for cardiovascular prevention in children and adolescents.
作为心血管疾病基础的动脉粥样硬化改变在儿童时期就可能开始。因此，心血管疾病的预防应在普通人群中尽早开展，并且有针对性地针对有心血管风险的人群。预防策略应包括鼓励身体活动、纠正饮食习惯以及减少接触污染物的措施。负责实施这些预防干预措施的主要行为主体是地方和国家政治当局。此外，应特别关注从受孕开始的生命最初一千天，以防止不利的表观遗传修饰。除了针对普通人群的举措外，医学界还应规划干预措施以评估个体风险状况。事实上，当前的肥胖流行使得在儿童和青少年中也相对频繁地出现一些在成年人中已知的心血管危险因素，如动脉高血压、血脂异常、糖代谢紊乱和尿酸值升高。本综述的目的是指出儿童和青少年心血管预防的干预方向。
