New Alliance Aims to Prevent Heart Disease by Focusing on Childhood Risk Factors
A new alliance of public health and clinical experts has been formed in Australia with the stated goal of preventing cardiovascular disease by addressing risk factors beginning in childhood. The group cites data showing unfavorable cardiovascular risk factors are common and increasing among Australian children and argues that a shift in prevention strategy is needed.
Formation and Goal of the Alliance
The Healthy Start for Young Hearts Alliance has been established, bringing together experts from public health and clinical care fields. The alliance's stated aim is to prevent cardiovascular disease by focusing on modifiable risk factors in childhood.
Background and Rationale
Cardiovascular disease has traditionally been viewed as a condition affecting older adults. Recent evidence cited by the alliance indicates that targeting modifiable risk factors in childhood could prevent approximately 30% of adult cardiovascular disease.
Current Data on Australian Children's Health
The alliance references data from the Australian Institute of Health and Welfare (AIHW) to outline current trends:
- In 2022, 26% of children and adolescents aged 2 to 14 years were living with overweight or obesity.
- AIHW projections indicate this percentage could rise to 50% by 2050.
- In 2020-2021, fewer than 10% of children and adolescents aged 2 to 17 years consumed the recommended amount of fruit and vegetables.
- In 2022, approximately 20% of children aged 5 to 18 years met current physical activity recommendations.
Reported Challenges in Prevention
The alliance identifies several challenges in the current approach to prevention:
- Australian general practitioners report not being adequately supported to deliver preventative healthcare activities, including nutrition and physical activity guidance.
- General practitioners report low self-efficacy in working with patients to implement weight management and lifestyle changes.
- The adoption and implementation of recommendations from recent national health strategies have been described as underwhelming.
- Less than 2% of Australia's healthcare spending goes toward prevention, with only a small fraction of that focused on childhood prevention.
- Total annual spending on cardiovascular disease in Australia is nearly $17 billion.
Research on Lifetime Risk
The alliance references research findings on lifetime cardiovascular risk:
The lifetime risk of a major atherosclerotic cardiovascular event is approximately 30% for individuals with one suboptimal risk factor, and approximately 70% for those with two or more.
- The lifetime risk for individuals who maintain optimal risk factor levels into mid-life is less than 8%.
- Research indicates that improving elevated risk factors does not provide the same low level of risk as maintaining optimal levels from childhood. For example, individuals treated to optimal blood pressure levels have a lower cardiovascular disease risk than those with uncontrolled blood pressure, but double the risk of those who have always maintained optimal levels.
Proposed Approach
The Healthy Start for Young Hearts Alliance advocates for a coordinated, multi-pronged strategy, which it states includes:
- Addressing environmental and behavioral drivers of risk.
- Co-designing solutions with communities.
- Translating evidence into policy and services.
- Embedding preventive clinical pathways for children at elevated risk.
The authors state that reversing current trends will require system-level change and depends on collaboration among researchers, clinicians, implementation scientists, economists, policymakers, funders, and communities.
Author Information and Disclosures
The announcement was authored by:
- Dr. Rachel Climie, NHMRC Emerging Leader Fellow and Heart Foundation Future Leader Fellow at the Menzies Institute for Medical Research, University of Tasmania.
- Jonathan Mynard, Senior Research Fellow at the Murdoch Children's Research Institute and Honorary Principal Fellow with the Department of Paediatrics at the University of Melbourne.
- Sherly Li, a paediatric dietitian and nutritional epidemiologist at the Murdoch Children's Research Institute.
- Terry Dwyer, Principal Fellow at the Murdoch Children's Research Institute.
The authors state they do not work for, consult, own shares in, or receive funding from any company or organization that would benefit from the article and have disclosed no relevant affiliations beyond their academic appointments. They note that the statements or opinions expressed reflect their views and do not necessarily represent the official policy of the AMA, the MJA, or InSight+.