Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents: Recommendations for Standard Assessment for Clinical Research: A Scientific Statement From the American Heart Association

• Published in: Hypertension (Dallas, Tex. 1979) Vol. 54; no. 5; pp. 919 - 950
• Main Authors: Urbina, Elaine M., Williams, Richard V., Alpert, Bruce S., Collins, Ronnie T., Daniels, Stephen R., Hayman, Laura, Jacobson, Marc, Mahoney, Larry, Mietus-Snyder, Michele, Rocchini, Albert, Steinberger, Julia, McCrindle, Brian
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD American Heart Association, Inc 01.11.2009; Lippincott Williams & Wilkins
• Subjects: Adolescent; Age Factors; American Heart Association; Arterial hypertension. Arterial hypotension; Atherosclerosis - diagnosis; Atherosclerosis - pathology; Biological and medical sciences; Biomedical Research - standards; Blood and lymphatic vessels; Blood Flow Velocity - physiology; Cardiology. Vascular system; Cardiovascular Diseases - pathology; Cardiovascular Diseases - prevention & control; Carotid Stenosis - diagnostic imaging; Carotid Stenosis - pathology; Child; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Diagnostic Imaging - methods; Disease Progression; Endothelium, Vascular - pathology; Endothelium, Vascular - physiopathology; Female; Humans; Image Interpretation, Computer-Assisted; Magnetic Resonance Angiography; Male; Manometry; Medical sciences; Oscillometry; Practice Guidelines as Topic; Risk Assessment; Tunica Media - pathology; Tunica Media - physiopathology; Ultrasonography, Doppler; United States; Vascular Resistance; Human; Hypertension; vasculature; risk factors; American; Brachial artery; Elasticity; Cardiovascular disease; Asymptomatic; carotid arteries; Recommendation; AHA Scientific Statements; Vascular disease; elasticity imaging technique; Carotid; Scientific research; Adolescent; Atherosclerosis; Risk factor; pediatrics; Child
• ISSN: 0194-911X; 1524-4563; 1524-4563
• DOI: 10.1161/HYPERTENSIONAHA.109.192639

Deterioration in endothelial function and arterial stiffness are early events in the development of cardiovascular diseases. In adults, noninvasive measures of atherosclerosis have become established as valid and reliable tools for refining cardiovascular risk to target individuals who need early intervention. With limited pediatric data, the use of these techniques in children and adolescents largely has been reserved for research purposes. Therefore, this scientific statement was written to (1) review the current literature on the noninvasive assessment of atherosclerosis in children and adolescents, (2) make recommendations for the standardization of these tools for research, and (3) stimulate further research with a goal of developing valid and reliable techniques with normative data for noninvasive clinical evaluation of atherosclerosis in pediatric patients. Precise and reliable noninvasive tests for atherosclerosis in youth will improve our ability to estimate future risk for heart attack and stroke. Currently, large longitudinal studies of cardiovascular risk factors in youth, such as the Bogalusa and Muscatine studies, lack sufficient adult subjects experiencing hard outcomes, such as heart attack and stroke, to produce meaningful risk scores like those developed from Framingham data.