Published online June 1, 2007
PEDIATRICS Vol. 119 No. 6 June 2007, pp. 1204-1206 (doi:10.1542/10.1542/peds.2007-0833)
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COMMENTARY

Pediatric Prevention of Atherosclerosis: Targeting Early Variation in Vascular Biology

Paul Leeson, PhD, MRCP

Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom

The first 20% of the full text of this article appears below.

Atherosclerosis first appears during childhood.1 Therefore, interventions may need to be started much earlier, and targeted at biological pathways that determine disease susceptibility, to prevent adult cardiovascular disease. In this issue of Pediatrics, Martin et al2 put forward the hypothesis that folic acid intake during in utero and early postnatal life may be relevant to longer-term risk of cardiovascular disease. This suggestion is based on their observation that folate levels in the immediate postnatal period are associated with endothelial function.

The endothelium has a key biological influence on the development of cardiovascular disease. Endothelial responses relate to an individual's risk of cardiovascular events,3 and in animal models, loss of endothelial function leads to accelerated atherogenesis and the development of hypertension and glucose intolerance.4,5 Approximately 10 years ago it was observed that there was significant variation in endothelial function between individuals during childhood.6,7 This variation did not relate to levels of classical cardiovascular risk factors, an important determinant . . . [Full Text of this Article]

Address correspondence to Paul Leeson, PhD, MRCP, Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom. E-mail: paul.leeson@cardiov.ox.ac.uk


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