Pediatric Precursors of Atherosclerosis

Clinical manifestations of coronary heart disease (CHD), cerebrovascular disease (CVD), and peripheral vascular disease (PVD) as well as the clinical sequellae of hypertension, are generally not present in children. However, the evidence that the atherosclerotic lesion has its anatomic origins in childhood and adolescence is both broad-based and persuasive. The presence of anatomically and hemodynamically advanced coronary artery occlusion in young war victims unselected for coronary heart disease risk factors indicates that occlusive atherosclerosis is well underway in young American men by their late teens and early twenties.