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Updated guidelines, comprehensive review, and an investment of resources into pediatric preventive cardiology programs could help provide successful care.
Preteens and teens are presenting with more progressive health conditions that put these adolescents at risk for premature cardiovascular illnesses when they are adults. New study findings from the American Heart Associationshow that early screenings and diagnosis are a crucial preventative step, although there are not enough resources for the needs of pediatric preventive cardiology (PPC) care.
“Cardiovascular disease risk factors starting in childhood have important implications for health, quality of life, health care costs, and societal costs across the whole life course,” said Amanda Marma Perak, MD, MS, FAHA chair of the science advisory writing committee and an assistant professor of pediatrics (cardiology) and preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago, in a press release.
The American Heart Associationscience advisory reports that 39% of US children and young adults between the ages of 12 and 19 are diagnosed with obesity or being overweight, while 18% have prediabetes and 15% have elevated blood pressure. Each of these conditions will present an increased risk of a heart attack or stroke when they enter their 40s or 50s.
The study authors note that although there are PPC programs in place, getting access to them has become difficult due to a vast number of referrals, creating long wait times to receive an appointment. To provide more research on these programs, the American Heart Association writing advisory surveyed the directors of pediatric cardiology divisions at university hospital and lead clinicians at PPC programs in the United States and Canada.
The first survey asked questions about specific characteristics of the practice on PPC program needs. The division directors reported that most of the pediatric cardiology divisions are large and provided other aspects that would benefit the program. Some of these benefits include providing care for children and teens with lipid disorders, high blood pressure, obesity, or family history of heart disease. Half of the directors reported that a psychologist or behavioral therapist would be beneficial to add to the team as others reported a social worker. However, one-third reported that a genetic counselor, vascular specialist, administrative assistant, or research associate would be more beneficial.
The second survey asked questions about current practices, offered therapies, and future plans. The lead clinicians reported that there is higher demand than the supplies being offered and wait times can exceed 3 months to receive an appointment. The respondents appeared to be divided as 37% of clinicians were trying to build on their programs and 34% were overwhelmed with the number of patients. They also reported that not many training opportunities were being offered, as only 2 of 41 programs had fellowship training.
The study authors noted that these findings represent different challenges for resources because of the vast ideas each individual reported could be beneficial.
“The advisory calls on professional societies and foundations to advocate for PPC programs and to support PPC education, training, and opportunities for networking and collaboration. The writing group calls for new research to fill gaps in the evidence about how to best prevent heart disease and stroke in children with risk factors, particularly those with high blood pressure and high cholesterol. They also identify the need to study novel ways to provide care and how to effectively implement lifestyle interventions in racially and economically diverse pediatric populations,” said the authors of the study.
The findings suggest that updated guidelines, comprehensive review, and an investment of resources into PPC programs could help provide successful care.
Reference
Survey of CVD programs finds more resources needed for heart disease and stroke risk in youth. EurekAlert!. News release. August 7, 2023. Accessed August 7, 2023. https://www.eurekalert.org/news-releases/997791.