Pediatric atherosclerosis

At Children's Health℠, we have become a “home base” of comprehensive care for children at risk for developing atherosclerosis (ath·​ero·​scle·​ro·​sis). We are one of the few hospitals in the country that provides comprehensive diagnosis and treatment for both high blood pressure and high cholesterol in children — the two top contributors to atherosclerosis.

As the children we treat grow up, we also help transition them into adult care programs at UT Southwestern. That way, your child can achieve lasting heart and blood vessel health through continued access to the care that will help them live long, fulfilling lives.

What is pediatric atherosclerosis?

Pediatric atherosclerosis - Children's Health Heart CenterAtherosclerosis is the hardening and narrowing of arteries due to the buildup of a plaque made of fat cells (lipids) and cholesterol in the arteries. Atherosclerosis increases the risk of heart disease, stroke and cardiac arrest. Just like adults, children can be diagnosed with atherosclerosis. However, atherosclerosis is more likely to be asymptomatic in children than it is in adults.

Arteries are tiny tubes in the body that circulate blood from the heart to tissues and organs throughout the body. When the tubes become narrowed, they are not as efficient at transporting blood. And the plaque builds up in the arteries can cause various cardiovascular health problems.

The good news is, in most children with atherosclerosis, damage to the arteries is mild. And the disease’s progression can be stalled or even reversed through treatment.

What are the signs and symptoms of pediatric atherosclerosis?

  • High cholesterol and triglycerides
  • Chest pain or pressure
  • Heart attacks, strokes and early cardiac events

How is pediatric atherosclerosis diagnosed?

Pediatric atherosclerosis can be harder to detect than adult atherosclerosis, especially in younger kids. This is because the damage the disease causes happens over time. So, our providers diligently and proactively assess children’s risk factors for atherosclerosis.

As we evaluate your child’s risk for atherosclerosis, we may:

  • Take a blood sample to assess cholesterol and triglyceride levels
  • Ask questions about your family's history of cardiac events
  • Recommend genetic testing

Some children may not get diagnosed until their teenage years, once atherosclerosis has had a chance to affect their arteries and heart. For children diagnosed with atherosclerosis, we may recommend doing cardiac imaging to assess how well treatment is working when they become a teenager.

While some children with atherosclerosis may not have symptoms, early diagnosis and treatment is vital to preventing a medical emergency later in life for your child. The sooner we can diagnose and treat your child, the better we can slow, stop or even reverse the damage atherosclerosis can cause.

What causes pediatric atherosclerosis?

There are various risk factors for children developing atherosclerosis, including:

  • Chemotherapy - Some chemotherapy treatments can cause problems in the heart and vascular system.
  • Chronic kidney disease (CKD) - Chronic kidney disease has been linked to cardiovascular disease.
  • Depressive and bipolar disorders - Depression and anxiety disorders can contribute to heart disease by affecting heart rhythms, blood pressure, blood clotting, insulin, and cholesterol.
  • Diabetes - High glucose (sugar) levels in the blood can damage blood vessels.
  • Dyslipidemia - A disorder that affects cholesterol levels.
  • Family history - Cardiovascular disease can run in families.
  • Heart transplant - This procedure can cause problems in the heart and vascular system.
  • High blood pressure - (also called hypertension) damages the lining of the arteries, making them more susceptible to plaque.
  • High cholesterol or triglycerides - Cholesterol and triglycerides are types of lipids, or fat, in the blood that help us turn food into energy, but too high levels of them can cause plaque that clogs arteries.
  • Kawasaki disease - Causes inflammation of blood vessels throughout the body.
  • Obesity, an unhealthy diet and an inactive lifestyle - These things can increase blood pressure and glucose levels, raise cholesterol levels, cause inflammation in the arteries and cause other problems with the heart and vascular system.
  • Smoking and secondhand smoke - Smoking damages the lining of arteries, making them susceptible to fatty buildup.

How is pediatric atherosclerosis treated?

Our goal for pediatric atherosclerosis treatment is to lower your child’s cholesterol levels.

This will likely include:

  • Statins - These medications, which can be prescription or over-the-counter, lower cholesterol and bring down the swelling in your child’s arteries. There are usually no or very few side effects from using statin medications long-term. They are the best way to set your child’s bloodstream up for lasting success and your child can safely take these medications into adulthood.
  • Developing healthy lifestyle habits - A healthy diet will help bring your child’s cholesterol levels down by limiting how many lipids enter their bloodstream. Consistent exercise will help your child use up the lipids that do enter their bloodstream before they can accumulate into plaque. Our team of nutrition experts will also help your child come up with a nutrition plan that matches their preferences and routine.
  • Treatment plan - Our specialists work with your child to create a treatment plan tailored to their needs and preferences so they are more likely to successfully complete the program. Once we develop a treatment plan for your child, we’ll see them every 6 months for the first year of their care. After that, we’ll need to see them once a year to ensure the treatment is effective.

Frequently Asked Questions

  • Does my child need to take these medications for the rest of their life?

    Yes. Not taking medication consistently can lead to emergency events, such as heart attack or strokes. Our team of expert pediatric cardiologists are involved in research working to develop a new medication that would be a once-a-year injection that could lower a child’s cholesterol by up to 70%.

    There are also other injection medications already available that are only required a few times each year. Until these medications become more widely available, daily oral statin medications are the best way to ensure your child’s atherosclerosis does not progress, however, if your child struggles to routinely take their medications, ask your pediatric cardiologist about newer injection medications that have (or are about to) become available.

  • Can early atherosclerosis be reversed?

    Yes. The child will always have to take the medications to do this, however, treating kids early on in childhood offers a chance to reverse the disease over time and eventually stop it from causing any damage to your child’s heart and arteries.

    If we can treat kids before plaque forms, we can reverse the disease completely. If your child develops atherosclerosis to the point where plaque starts to form in their arteries, it can be much harder to break that down and reverse the disease’s progression.