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(Hypertension. 2009;54:919.)
© 2009 American Heart Association, Inc.

AHA Scientific Statement

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