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Cardiovascular Risk in Preschool Children

USC University Center of Excellence in Developmental Disabilities, lyin{at}chla.usc.edu, Childrens Hospital Los Angeles, USC Keck School of Medicine

Hope Wills, MA, RD

USC University Center of Excellence in Developmental Disabilities, Childrens Hospital Los Angeles

Noreen Clarke, RN, MSN

USC Keck School of Medicine, USC University Center of Excellence in Developmental Disabilities, Childrens Hospital Los Angeles

Janice Shacks, RN, PHN

Infant Preschool Support Services, Los Angeles Unified School District, Los Angeles, California

Christine Bottrell

Harvard University School of Public Health, Boston, Massachusetts, University of California, San Francisco

Marie K. Poulsen, PhD

USC Keck School of Medicine, USC University Center of Excellence in Developmental Disabilities, Childrens Hospital Los Angeles

The objective of this study is to determine the prevalence of cardiovascular risk in a primarily Latino/ Hispanic preschool population of low socioeconomic status. Preschool health screenings were conducted as part of a publicly funded demonstration project designed to provide consultation, education, services, and support to children living in underserved communities. Cross-sectional analysis was restricted to 2- to 5-year-olds with recorded values for age, gender, ethnicity, height, weight, triceps skinfold, resting heart rate, and blood pressure, resulting in 608 subjects. Most of the study population was of Latino/Hispanic descent. The prevalence of overweight and obesity rivaled adult data, with almost 50% of preschoolers aged 2 to 5 years being overweight or obese. Prevalence of overweight/obesity did not vary by age or gender. The Latino/Hispanic population had a significantly greater prevalence of overweight and obesity (P = .003, P = .02), but severe obesity (body mass index 99th percentile) did not vary by ethnicity. Obesity and severe obesity were independent risk factors for systolic blood pressure in the hypertensive range (relative risk [RR] = 2.45, 95% confidence interval [CI] = 1.73-3.45, P < .0001; RR = 2.53, 95% CI = 1.46-4.38; P = .001, respectively). The risk of cardiovascular disease is high in the preschool population studied, especially in the severely obese. Adverse risk was identified in obese children as early as 2 years old. Economically disadvantaged children, particularly of Latino/ Hispanic descent, may be at higher risk. This is an important consideration given population projections by 2050. These findings support the need for earlier intervention as the preschool years may be a more feasible and effective period for intervention.

Key Words: hypertension • obesity • overweight • poverty • preschool

ICAN: Infant, Child, & Adolescent Nutrition, Vol. 1, No. 4, 197-204 (2009)
DOI: 10.1177/1941406409341077


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