Childhood determinants of vascular damage and body mass index in young adulthood

Throughout the past 50 years, cardiovascular disease (CVD) has been the leading cause of morbidity and mortality in most modern societies. In 2002, almost 50,000 persons died of CVD in the Netherlands, accounting for 33.7% of all deaths. Aging of the population and improved survival after CVD events bear heavily on medical costs. In order to delay the development of atherosclerosis and hence decrease the incidence of CVD, it is essential to improve primary prevention of CVD. About four or fi ve decades ago, the concept of risk factors was introduced, largely as a result of the work done in the Framingham Heart Study. Since then, extensive research has been done to examine the role of risk factors in the development of atherosclerosis and CVD. It has been established that one can successfully reduce the incidence of CVD by reducing or even eliminating risk factors for this disease. In addition, the decrease in the age-adjusted cardiovascular mortality rate, that is seen from the 1970s onwards, can be attributed to improved treatment, but also to secondary prevention and primary prevention, each accounting for a 25% decrease in CVD mortality.4 Many successful preventive campaigns have aimed at creating more awareness among adults and drawing attention to people’s own responsibility concerning their body and health. In the current view, the best way to reduce one’s risk for CVD is to live as healthy as possible by exerting regular physical activity, refraining from smoking, consuming alcohol only moderately and by a healthy diet. Furthermore, much research has been devoted to gaining insight into less traditional factors that contribute to the initiation and progression of CVD. For example, in recent years, infl ammation is recognized as a putative cause of atherosclerosis.

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