[I-AHAJS-02] Constructing a Preventive Cardiology Program: The Blood Pressure Perspective
Atherosclerotic cardiovascular disease (ASCVD) risk factors begin in childhood. Current paradigms place primordial and primary prevention at the center of efforts to reduce the future population burden of ASCVD. Data shows that youth blood pressure (BP) does predict future preclinical atherosclerotic changes in vasculature, cardiac remodeling, and eventually ASCVD events and mortality over the lifecourse. Therefore focusing on BP is a key cornerstone of any pediatric preventive cardiology practice. Properly constructed preventive programs should balance the proper determination of BP against the time required to measure multiple BPs, discerning essential versus secondary hypertension in young patients, identifying reactive hypertension, assessing BP in patients referred for other reasons, and assessment of target organ damage. Emerging domains include assessment of vascular measures as target organs of elevated BP damage, leveraging pediatric preventive cardiology practice toward population and policy interventions, and identifying features that ensure the financial sustainability of the pediatric preventive cardiology practice. Proper attention to these domains can make a concerted reduction in the population impact of future ASCVD.