Early intervention in dyslipidemias: an opportunity to prevent cardiovascular disease

Abstract

Atherosclerotic cardiovascular disease is the leading cause of morbidity and mortality in developed countries. Although its clinical manifestations usually occur in adulthood, atherosclerotic damage may begin silently at an early age. Its main determinant is cumulative exposure to atherogenic lipoproteins. Pediatric dyslipidemias are common, affecting approximately 19% of children and adolescents. Familial hypercholesterolemia, which has a significant prevalence in the population, is particularly relevant because of its association with premature atherosclerotic cardiovascular disease. Current international guidelines recommend improving screening strategies to facilitate diagnosis from an early age. Likewise, the role of lipoprotein(a) as a cardiovascular risk enhancer is becoming increasingly well established. Initial treatment of dyslipidemias is based on lifestyle optimization. Early initiation of pharmacological treatment, when indicated, has been shown to reduce the risk of cardiovascular events in adulthood. Primary Care pediatricians are in a privileged position for early detection and management, making childhood a unique window of opportunity to modify the future trajectory of cardiovascular risk.