It is widely known that heart disease is the number one killer of men and women in the United States. What is not appreciated is how early heart disease may begin in our youth. A recent study published in a highly regarded medical journal has focused our attention on teenagers. The study looked at 760 of the coronary arteries that feed the heart in teens and young adults who died in accidents, or by suicide or homicide. The researchers were astounded to find 2 percent of males aged 15 to 19 years, and 20 percent of men aged 30 to 34 years had advanced plaques, capable of rupture and causing a heart attack. Girls aged 15 to 19 did not show these plaques, but 8 percent of women aged 30 to 34 years did.

What is sobering to contemplate is that if these data can be extrapolated to the general population, one in five young male adults are at risk. If one adds obesity or high levels of “bad cholesterol”, that is, low-density lipoprotein (LDL) cholesterol, the risk increased 2.5 times. The epidemic of obesity in this country has also affect our youth. The relationship of obesity to high blood pressure and diabetes is well known. Weight reduction mitigates the risk of both.

Prevention programs and public health efforts are difficult to implement since people tend not to pay attention unless they are directly involved. When one then pays attention to what they can do to minimize their risk of heart disease, they are often amazed at the simple things they could have done at an earlier stage to have reduced the odds of being in their current predicament.

This recent report should cause all of us to draw a bead on the lifestyles that we are fortunate to enjoy, but which may need to be reined in a bit. If not for us, perhaps we should do so for our children. The usual health mantra of eating lower fat, calorically constrained diets, exercising at least 30 minutes three times per week, and avoiding tobacco still form the fundamental building blocks of a cardiovascular prevention strategy. When people become patients, I have found, they get religion. When people get away with an unhealthy lifestyle, they tend to push it until some evidence of a problem gives them pause.

If we are to achieve the goal of lowering heart disease risk, a proactive approach rather than the usual reactive stance would clearly be best. To find such advanced disease in our children should make us seek to set the example of a healthier lifestyle that just might rub off on our children. Not only would we be around longer to enjoy our families, but there could be no better legacy to give our most cherished treasures.