Family-directed preventive cardiology.

Cardiovascular events continue as the leading cause of death in the United States, despite a decline in recent years. Epidemiological evidence has confirmed that in adults smoking, high blood pressure, hypercholesterolemia, a family history of atherosclerotic disease at an early age, diabetes mellitus, and certain behavioral patterns are associated with a higher risk for myocardial infarction and other manifestations of coronary artery occlusion. In addition, a lack of regular physical activity, being overweight, and excess ethanol consumption are associated with increased cardiac disease rates. Since these indicators of risk may appear in childhood, and the earliest manifestations of atherosclerosis or hypertension can become manifest soon thereafter, the prevention of cardiovascular events must begin early. This paper reviews the evidence for the origins of cardiovascular risk in childhood, and offers recommendations to family physicians to help them provide parents with the proper information, motivation, and skills to teach their children healthy nutritional, exercise, and behavioral patterns.