Cardiovascular prevention in childhood: a consensus document of the Italian Society of Cardiology Working Group on Congenital Heart Disease and Cardiovascular Prevention in Paediatric Age.

Autor:	Martino F; Department of Internal Clinical, Anesthesiological and Cardiovascular Sciences, La Sapienza University, Rome, Italy., Bassareo PP; University College of Dublin, School of Medicine, Mater Misericordiae University Hospital and Children's Health Ireland at Crumlin, Dublin, Ireland., Martino E; Department of Internal Clinical, Anesthesiological and Cardiovascular Sciences, La Sapienza University, Rome, Italy., Romeo F; UniCamillus International Medical University, Rome., Calcaterra G; University of Palermo, Post graduate Medical School, Palermo., Perrone Filardi P; Department of Advanced Biomedical Sciences, Federico II University, Naples., Indolfi C; Division of Cardiology, Research Centre for Cardiovascular Diseases, Magna Graecia University, Catanzaro., Nodari S; Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili, Brescia., Montemurro V; 'Scillesi d'America' Hospital, Scilla, Reggio Calabria., Guccione P; Department of Cardiology, Cardiac Surgery, Cardio-pulmonary Transplantation, IRCCS Bambino Gesu'Paediatric Hospital, Rome., Salvo GD; Division of Paediatric Cardiology, Department of Women's and Children's Health, University of Padua, Padua., Chessa M; ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS-Policlinico San Donato, San Donato Milanese, Vita Salute San Raffaele University, Milan., Pedrinelli R; Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa., Mercuro G; University of Cagliari, Cagliari., Barillà F; Department of Systems Medicine, Tor Vergata University, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Journal of cardiovascular medicine (Hagerstown, Md.) [J Cardiovasc Med (Hagerstown)] 2023 Aug 01; Vol. 24 (8), pp. 492-505. Date of Electronic Publication: 2023 Jun 26.
DOI:	10.2459/JCM.0000000000001488
Abstrakt:	Cardiovascular diseases (CVD) may be manifested from a very early age. Genetic and environmental (epigenetic) factors interact to affect development and give rise to an abnormal phenotypical expression of genetic information, although not eliciting changes in the nucleotide sequence of DNA. It has been scientifically proven that increased oxidative stress (OS) caused by disease (overweight, obesity, diabetes), nutritional imbalances, unhealthy lifestyles (smoking, alcohol, substance abuse) in the mother during pregnancy may induce placental dysfunction, intrauterine growth restriction, prematurity, low birth weight, postnatal adiposity rebound, metabolic alterations and consequent onset of traditional cardiovascular risk factors. OS represents the cornerstone in the onset of atherosclerosis and manifestation of CVD following an extended asymptomatic period. OS activates platelets and monocytes eliciting the release of pro-inflammatory, pro-atherogenic and pro-oxidising substances resulting in endothelial dysfunction, decrease in flow-mediated arterial dilatation and increase in carotid intima-media thickness. The prevention of CVD is defined as primordial (aimed at preventing risk factors development), primary (aimed at early identification and treatment of risk factors), secondary (aimed at reducing risk of future events in patients who have already manifested a cardiovascular event), and tertiary (aimed at limiting the complex outcome of disease). Atherosclerosis prevention should be implemented as early as possible. Appropriate screening should be carried out to identify children at high risk who are apparently healthy and implement measures including dietary and lifestyle changes, addition of nutritional supplements and, lastly, pharmacological treatment if risk profiles fail to normalise. Reinstating endothelial function during the reversible stage of atherosclerosis is crucial. (Copyright © 2023 Italian Federation of Cardiology - I.F.C. All rights reserved.)
Databáze:	MEDLINE
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