Hypertension. 2009;54:919-950
Published online before print September 3, 2009,
doi: 10.1161/HYPERTENSIONAHA.109.192639
(Hypertension. 2009;54:919.)
© 2009 American Heart Association, Inc.
Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents
Recommendations for Standard Assessment for Clinical Research: A Scientific Statement From the American Heart Association
Elaine M. Urbina, MD, FAHA, Chair;
Richard V. Williams, MD;
Bruce S. Alpert, MD, FAHA;
Ronnie T. Collins, MD;
Stephen R. Daniels, MD, PhD, FAHA;
Laura Hayman, PhD, RN, FAHA;
Marc Jacobson, MD, FAHA;
Larry Mahoney, MD, FAHA;
Michele Mietus-Snyder, MD;
Albert Rocchini, MD, FAHA;
Julia Steinberger, MD, MS;
Brian McCrindle, MD, MPH, FAHA on behalf of the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young
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.
Key Words: AHA Scientific Statements pediatrics elasticity imaging technique brachial artery risk factors vasculature carotid arteries
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