Childhood antecedents to adult cardiovascular disease
Many of the most common and costly chronic adult health conditions have their origins in childhood and adolescence. This recognition is leading to both a profound shift in our understanding about the developmental origins of diseases such as hypertension, dyslipidemia, and type 2 diabetes mellitus (DM) and a greater focus on how different risk and protective factors influence the developmental pathways that determine optimal health across the life span. Scientific breakthroughs in the basic, clinical and epidemiological sciences reveal how different stressors and exposures during what are now termed “critical” or “sensitive” periods of development can affect growth, tissue differentiation and physiologic set points that influence an individual’s response to metabolic, physiologic, emotional and environmental challenges throughout life. In light of this explosion of new scientific data about the importance of the early years for lifelong health and development, general pediatricians will have to play an increasing role in addressing childhood antecedents to adult cardiovascular diseases (CVDs).