Obesity in childhood and cardiovascular disease risk

In adults, obesity is independent risk factor for cardiovascular diseases. However its influence through other risk factors (arterial hypertension, hypercholesterolemia, diabetes) is even stronger. An increasing number of studies with children and adolescents suggest, more or less directly, the same significant association between obesity and cardiovascular diseases. In this paper, a review of secondary cardiovascular complications of obesity in childhood is given. Such complications include: arterial hypertension, obesity cardiomyopathy, obstructive sleep apnoea with consequential pulmonary hypertension and cor pulmonale, dyslipidemia, atherosclerosis, type II diabetes, metabolic syndrome. The evaluation of an obese child or adolescent should include careful consideration of these possible cardiovascular complications. If they are present, treatment should be directed at both the cardiovascular complication and the underlying obesity. Some of the complications require a more immediate and aggressive approach than others, for example severe obstructive sleep apnoea. At the others, for example mild hypertension, dyslipidemia, glucose intolerance, non-pharmacologic measures should be started. If non-pharmacologic treatment is not successful, then