Background: Cardiovascular diseases are the leading cause of death worldwide. While
cardiovascular disease typically does not occur until adulthood, the pathogenesis of atherosclerotic
cardiovascular disease starts in early childhood.
Objective: The purpose of this review is to describe the evidence that the process of atherosclerosis
begins in childhood, as well as identify the risk factors present in childhood that are associated with
the presence of atherosclerotic cardiovascular disease in childhood as well as future cardiovascular
events in adulthood.
Results and Conclusion: There is much accumulating evidence linking modifiable risk factors that
are already present in childhood and that strongly predict future cardiovascular disease. The selective
targeting of modifiable risk factors in childhood, including body mass index, holds promise in
reducing the burden of adult cardiovascular disease. Future research studies should focus on elucidating
the mechanisms which drive the pathogenesis of atherosclerosis in childhood and young
adulthood, as well as identifying which interventions are most effective at limiting the progression
of atherosclerosis and thus reducing future cardiovascular disease.