A glimpse inside the neck arteries of obese children and teens reveals cardiovascular systems more like those of 45-year-olds, researchers said Tuesday.
Scientists using ultrasound imaging detected fatty deposits more typical in middle-aged adults than in children as young as 10, underscoring worries about accelerated risks of heart disease decades earlier than once thought possible.
"There's a saying that you're as old as your arteries," said the study's lead author, Dr. Geetha Raghuveer, associate professor of pediatrics at the University of Missouri Kansas City School of Medicine. "These kids are showing up with arteries that show middle-aged conditions."
In fact, more than half of the 70 youngsters enrolled in the Children's Mercy Hospital study had a "vascular age" about 30 years older than their actual age, putting them at risk for early heart attacks, stroke — and death. The research was presented Tuesday at the American Heart Association's scientific meeting in New Orleans.
That finding might also hold true for many more young people in the United States, where more than 16 percent of kids ages 2 to 19 are considered obese, according to federal statistics.
"It kind of hammers home that the risk might be speeded up," said Dr. Stephen Daniels, chief pediatrician at the Children's Hospital in Denver, who was not associated with the new study. "It does kind of fit with the concept that kids with high cholesterol and other risk factors probably have premature aging factors."
This isn't the first time aging arteries have been documented in kids. Previous studies have reported that growing numbers of children with risk factors for heart disease are showing signs of narrowing and hardening of the arteries, conditions typically associated with adults.
But Raghuveer and her colleagues used ultrasound imaging to measure the thickness of the inner walls of the carotid arteries that supply blood to the brain. Increasing carotid artery intima-media thickness, or CIMT, indicates a build-up of fatty deposits, known as plaque, in crucial arteries to the heart and brain. Plaque build-up in the arteries, which is usually affects adults, can restrict the flow of blood, causing heart attacks or stroke.
Then they plotted the measurements on a graph for adult plaque levels — because similar measures don't exist for kids.
The small study included children ages 6 to 19, but most were ages 10 to 18 and the average age was 13, Raghuveer said.
The children's average CIMT was .45 millimeters, with a maximum of .75 millimeters. One 12-year-old boy logged a CIMT of .54, which placed him smack in the middle of measurements expected to be seen in a healthy 45-year-old man — .50 millimeters to .57 millimeters.
"If I see a kid with a .54 plaque in his carotid artery, a 12-year-old kid, I'm going to be concerned," Raghuveer said.
Youngsters most at risk in the study were those who were obese, with body mass index or BMI at or above the 95th percentile, and those who had abnormally high cholesterol levels, including either too much of the so-called "bad" LDL cholesterol, or too little of the "good" HDL cholesterol.
In addition, some children and teens had levels of fat chemicals known as triglycerides far above optimum levels.
'It was just alarming'
That group included Nick Calvert, a 17-year-old high school junior from Kansas City, Mo. His triglycerides topped out at more than 500 milligrams per deciliter, nearly triple the recommended 150 mg/dl that is considered acceptable.
"Well, it was very upsetting," said Nick's mother, Lisa Calvert, 41, a homemaker and mother of three who long ago stopped cooking with butter. "It was just alarming. I felt like I needed to sit down and talk to him."
Nick was stocky, but not obese, weighing at 182 pounds on a 5-foot-9 frame. But he's been struggling with genetically high cholesterol levels since he was 2, and a typical teen diet didn't help.
"I'd go out with my friends and they'd eat and I'd eat, too," said Nick, who acknowledged a fondness for burgers and pop.
When the ultrasound also detected thickening in his carotid arteries, Nick and his family got scared. He signed up with a personal trainer and started watching his diet, swapping burgers for grilled chicken and soda for water and tea.
"If I don't do it, I could have a heart attack or stroke at a younger age," said Nick, who has lost 20 pounds in the past few months, dropping him to 162 pounds.
That kind of proactive attitude is vital, said Dr. Samuel S. Gidding, chief of pediatric cardiology at the Alfred I. duPont Hospital for Children in Wilmington, Del.
Children and teens don't typically suffer heart attacks, but they can be at risk for early signs of heart disease, said Gidding. He noted that Raghuveer's work confirms previous autopsy studies that showed a strong link between budding heart disease and risk factors in young people.
Changing diet and increasing exercise can slow and perhaps stop deterioration, he said. Although the American Academy of Pediatrics recently recommended cholesterol-lowering drugs for kids as young as 8, Gidding said he's waiting to release new guidelines through the National Heart, Lung and Blood Institute, NHLBI, next year.
In the meantime, the new research is a reminder to take steps to prevent obesity and high cholesterol before children's arteries grow older than their years, Raghuveer said.
"I'm very hopeful we can reverse this process," she said.