Staying Young at Heart: Cardiovascular Disease Prevention in Adolescents and Young Adults

Abstract

OPINION STATEMENT Approaches to the prevention and management of cardiovascular disease (CVD) are often too narrow in scope and initiated too late. While the majority of adolescents are free of CVD, far fewer are free of CVD risk factors, especially lifestyle factors such as poor exercise and dietary habits. Most clinicians are familiar with behavioral and pharmacologic strategies for modifying these and other traditional CVD risk factors such as hypertension, hypercholesterolemia, and diabetes. In this review, we highlight those strategies most applicable to teens and also propose a fundamental reframing that recognizes the importance of early choices and life experiences to achieving cardiovascular health. Population- and individual-level approaches that support the establishment of positive health behaviors early in life are the foundation of preserving ideal cardiovascular health and promoting positive cardiovascular outcomes. The Positive Youth Development movement supports a frame shift away from seeing young people as merely the sum of their risk factors and instead as developmentally dynamic youth capable of making healthy choices. Informed by the Positive Youth Development framework, our approach to cardiovascular prevention among adolescents is both broad-based and proactive, paying heed as early as possible to social, familial, and developmental factors that underlie health behaviors, and employing evidence- based behavioral, pharmacologic, and surgical treatments when needed.

Assessing the validity of a data driven segmentation approach: A 4 year longitudinal study of healthcare utilization and mortality

“…Disease prevention, health education and robust primary care remain the strategies to maintain the health status of the “Young, healthy” and “Middle age, healthy” segments [ 44 ]. However, their low healthcare utilization presents a unique challenge because they had little contact with the healthcare institutions.…”

The Unchartered Frontier: Preventive Cardiology Between the Ages of 15 and 35 Years

“…Family and school-based programs are important for younger teens. While data on school-based programs to mitigate CVD risk behaviors are mixed [81•, 82], recent studies utilizing a positive youth development framework [83] to promote cardiovascular health in the school context have shown some promise [84]. For college-bound youth, campus efforts to combat the emergence of sedentary behaviors [85, 86•], suboptimal nutrition patterns [87, 88], weight gain [85, 89], and tobacco dependence [90] may be particularly important.…”

Longitudinal association between adolescent negative emotions and adulthood cardiovascular disease risk: an opportunity for healthcare quality improvement

“…Despite being born with optimal cardiovascular health, few maintain this profile in adolescence, continuing into adulthood. Data suggest that more than 50% of adolescents in the USA do not have ideal cardiovascular health metrics (Chung et al, 2015). Moreover, the unhealthy lifestyle of adults below the age of 45 portends a new epidemic of cardiovascular disease as they age (Andersson and Vasan, 2018).…”