The medical staff at the Preventive Cardiology Clinic is committed to helping reduce high rates of heart disease in the United States by heading it off at its earliest stages.
At a time when obesity and diabetes are on the rise among American children, the Preventive Cardiology team treats children who have these and other problems that may contribute to the development of heart disease in early adulthood.
Preventive Cardiology Clinic researchers have published studies on the following topics:
- Metabolic syndrome: In 2004, results from the study Prevalence of the Metabolic Syndrome in American Adolescents: Findings From the Third National Health and Nutrition Examination Survey were published in Circulation: Journal of the American Heart Association. The results of this study further underscore the need to start heart disease prevention efforts early in life.
- Inflammation: In 2006, a follow-up article was published in Clinical Chemistry explaining the findings of the 1988-1994 and 1999-2000 National Health and Nutrition Examination Surveys on metabolic syndrome. In recent years, inflammation has become a medical phenomenon, as researchers uncover its role in disease development, and as doctors offer tests that measure inflammation, as well as treatments aimed at controlling it.
Numerous studies in adults suggest that inflammation—the body’s way of responding to illness—plays a key role in atherosclerosis. Studies also show that the presence of high levels of the inflammation marker C-reactive protein (CRP) can predict heart attack or stroke in adults. Researchers at Children’s Hospital Boston are studying inflammation in children at risk for early atherosclerosis.
- Hypertriglyceridemia in children: To better understand elevated triglyceride levels in childhood, clinicians in the Preventive Cardiology Clinic reviewed the characteristics of children with this disorder, examining medications, reviewing family history, and monitoring weight and blood.
Controlling high triglycerides with omega-3
Clinicians at Boston Children's Hospital are conducting a trial to evaluate the efficacy of omega-3 fatty acids in reducing triglyceride levels in children aged 12 to 19 who have high levels of triglycerides.
Good cholesterol "too low"
A study by our researchers following nearly 2,000 adolescents found that low HDL—“good cholesterol”—was the most common risk factor of five major risk factors for atherosclerosis, or thickening of the arteries. Evidence shows that an HDL level in adults greater than, or equal to, 40 mg/dL is protective, while values below 40 mg/dL are considered a risk factor for coronary heart disease. Most children should have HDL levels of 50mg/dL or more. Triglycerides should be less than, or equal to, 150 mg/dL.
A clinical trial is a research study to answer specific questions about vaccines, new therapies or new ways of using known treatments. If your child’s doctor recommends participation in one of Boston Children’s clinical trials, that likely means that the doctor believes that the plan outlined in that trial represents the absolute best, latest care your child can possibly receive.
As part of its mission to advance the scientific understanding of atherosclerosis—the gradual hardening and narrowing of arteries that sets the stage for a heart attack or stroke—the Preventive Cardiology Clinic participates in, and recruits for, a wide range of research programs. Our research is aimed at furthering the understanding of the mechanisms behind atherosclerosis, as well as studying more effective and safe treatments for cholesterol, triglycerides and high blood pressure problems in children. Coming to the clinic does not automatically include your child in a study, nor is this required for treatment.
Current clinical trials
At any given time, Children’s has hundreds of clinical trials underway. Clinical trials currently available through the Preventive Cardiology Clinic include:
Use of Omega-3s in Adolescents with Mild to Moderately Elevated Triglycerides: Hypertriglyceridemia is a known complication of obesity and an important element of the metabolic syndrome. The optimal treatment for hypertriglyceridemia in childhood is not well known. Individuals with diets high in fish have been shown to have lower rates of cardiovascular disease, and omega-3 fatty acid supplements have been shown to successfully lower triglyceride levels in adults. Clinicians at Children’s Hospital Boston are conducting a trial to evaluate the efficacy of omega-3 fatty acids compared to placebo (dummy pill) in reducing triglyceride levels in youth ages 12-19 years old whose baseline triglycerides range from150 mg/dl to 1000 mg/dl.
PowerUp study: This clinical trial evaluates two heart-healthy diets in the treatment of adolescents with some heart disease risk factors associated with being overweight, such as high systolic blood pressure, pre-diabetes, insulin resistance and cholesterol disorders.
Participants in the study receive most meals and snacks in an amount designed to induce weight loss for eight weeks, and then are followed via telephone nutrition counseling during a four-month maintenance phase. Food is delivered to participants’ homes; participants and their families receive nutritional counseling during the food delivery visits.
The goal is to test whether either eating strategy is better at improving heart disease risk factors. Testing for cardiovascular risk factors is performed, and the results are provided to participants and their primary care providers. Children between the ages of 8 and 17 with two or more cardiovascular risk factors, but no other major medical issues, who are willing and eager to follow a healthy diet, may be eligible to participate.
Piloting an Interactive Fitness Program: Childhood obesity is an increasingly common risk factor for diabetes and cardiovascular disease (CVD). Research suggests exercise reduces cardiometabolic risk. Children’s Hospital Boston researchers are engaged in a collaborative feasibility project with researchers at UMass Boston’s GoKids facility and the children and staff at Russell Elementary School in Boston to assess whether an “exer-game” intervention improves levels of moderate or vigorous physical activity, CVD risk factors, fitness and self-perception in elementary school children. A Children’s Hospital Boston sub-study explores effects on lipids, insulin resistance, vascular reactivity and body composition. To be enrolled in this study, a child must be a student of Russell Elementary.