Thursday, July 24, 2014
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A teen heart risk parents can't ignore

There are plenty of studies these days warning that teens, preteens and even little kids have heart-disease risk factors that once only happened to adults ... but now a brand-new report paints a picture parents need to see.

A teen heart risk parents can't ignore

To avoid heart disease as they get older, experts say, we need to feed our kids real food – not fast food or processed foods. We need to shut off the TV, computer, X-box and get them outside to play and be physically active every day. (AP Photo/Eric Miller)
To avoid heart disease as they get older, experts say, we need to feed our kids real food – not fast food or processed foods. We need to shut off the TV, computer, X-box and get them outside to play and be physically active every day. (AP Photo/Eric Miller)

There are plenty of studies in the news these days warning that teens, preteens and even little kids have heart-disease risk factors that once only happened to adults ... but today a brand-new report paints a picture parents shouldn’t miss. Researchers in Finland took a look at the arteries of 589 middle-aged people - and found that those who had signs of high blood pressure and/or high LDL cholesterol as teenagers were up to three times more likely to have calcium deposits in the blood vessels in their hearts.

About one in five women and men in the study had calcium deposits in their coronary arteries. That’s bad news, because these calcium specks are an early sign of heart disease. Plaque’s building in artery walls - and that can squeeze down the size of arteries that carry blood to the heart or trigger a heart attack if plaque breaks open. How did middle-aged calcium deposits relate to teen blood pressure and cholesterol levels?

Teens with the highest levels of “bad” LDL cholesterol were 37 percent more likely to have calcium-lined arteries as adults. How high? Average LDL level in this group was about 132 - a level considered high by the National Heart, Lung and Blood Institute. The ideal LDL level for kids and teens is below 110.

Teens with the highest blood pressure readings were 38 percent more likely to have troubled arteries decades later. Average blood pressure for this group: About 120/70. Healthy blood pressure levels for teens depends on their age, gender and height. For example, healthy blood pressure for a  13-year-old girl of average height is around 109/64 and for a boy, around 110/63.

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What can you do? I asked Frances Zappalla, D.O., a pediatric cardiologist at the Nemours Cardiac Center at the Alfred I. duPont Hospital for Children in Wilmington, De.

Are there easy steps parents can take to help teens’ hearts stay healthy?

We need to teach our children healthy lifestyle habits as early as possible. We need to feed them real food – not fast food or processed foods. We need shut off the TV, computer, X-box and get them outside to play and be physically active every day. Recess and gym class (if they have gym at school) is not enough.

I tell families the easiest way to know what they should be eating is the closer the food looks to the way it looked in nature – the better it is for you.  Eating the apple – not the apple pie or apple juice.  Having a piece of grilled chicken or fish – not chicken nuggets or fish sticks.  More fruits and vegetables. Having at least one meatless day a week – vegetarian for a day getting your protein from beans or tofu. Read the ingredients.  What you eat should contain real food that is readily available in your kitchen so that you could reproduce that food if you were so inclined.  If you do not know what the ingredient is or can’t pronounce it – put it back on the shelf.

What about cholesterol and blood pressure checks. Should parents be sure teens get these?

Yes. Because we have known of these risks and the benefits of early treatment the National Institutes of Health announced last year the new recommendations that ALL children have a baseline lipid panel done between the ages of 9 and 11 years and if normal again between the ages of 17 to 21 years.  Those children who are high risk – diabetes, obesity, a strong family history of premature heart disease or a parent with high cholesterol, and children with chronic disease like kidney disease, Kawasaki disease, Juvenile Rheumatoid Arthritis, HIV, and Systemic Lupus should have the baseline lipid panel done earlier, between ages 2 to 8 years.

The recommendations for blood pressure monitoring and treatment came out several years ago.  All children over the age of two should be having their blood pressure checked at every well child visit.

How likely is it that a pediatrician will prescribe drugs for a teen with high blood pressure or high cholesterol?

The first line of treatment is diet and exercise. If there is no improvement after six months then the elevated blood pressure and cholesterol need to be treated with medication.  There is no advantage to waiting until they get older as this study and others have demonstrated.  Early treatment can prevent disease later in life. But lifestyle changes are really the key.  Eating the junk food and taking you Lipitor is not the answer.

It’s a tough job sometimes, getting teens to change their eating and exercise habits. Can it help?

Absolutely. I follow a young lady who I initially saw when she was 9 years old.  She was overweight with high cholesterol and high blood pressure. She and her family never made any changes. She went on to develop insulin resistance, Type 2 diabetes (what we used to call Adult Onset Diabetes), and fatty liver disease. Still no healthy lifestyle changes. 

But during her mid-adolescence something finally clicked!  She started to eat better. She cut out the soda and sugary drinks,  then junk food. She started exercising. When I saw her last summer as she was getting ready to start college, she was off all medications. Her weight was normal as were her blood pressure and cholesterol. She had completely changed her way her of eating and was exercising every day. This young lady completely changed her future by learning how to live a healthy lifestyle.

About this blog
Anna Nguyen Healthy Kids blog Editor
Stephen Aronoff, M.D., M.B.A. Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, M.D., Ph.D Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Mario Cruz, M.D. St. Christopher’s Hospital for Children, Drexel University College of Medicine
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist - The Anxiety Behaviors Clinic, CHOP
Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Lauren Falini Bariatric exercise physiologist, Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Children's Hospital of Philadelphia
W. Douglas Tynan, Ph.D. Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Flaura Koplin Winston, M.D., Ph.D Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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