Document Type


Publication Date



This article has been peer reviewed. It is the authors' final version prior to publication in Journal of Pediatrics Volume 158, Issue 4, April 2011, Pages 527-528. The published version is available at DOI: 10.1016/j.jpeds.2010.11.031 Copyright © Elsevier.


Each of the major cardiovascular risk factors presents unique challenges to the clinician caring for children. Dyslipidemia and hypertension are silent and require measurement; the challenge is first risk classification and then communicating strategies for treatment, with attendant cost, in the absence of perceptible disease morbidity. Obesity and physical inactivity, while generally obvious to the patient, require change in lifestyle for successful management; the challenge is to convince the patient to make that change. Diabetes mellitus is a significant disease requiring complex management strategies for the patient to execute; the challenge is to add cardiovascular risk reduction strategies to the difficulties of regular diabetes treatment. Tobacco use is an addiction; the challenge is the lack of useful prevention or treatment strategies available in the pediatric office setting.

PubMed ID