Cardiovascular disease is still the leading cause of mortality and morbidity in the United States, and it’s been on the rise in children in recent decades. According to 2016 CDC data, an estimated one in 77 has a heart condition.
Some heart disease is acquired, for instance, through infections or trauma. However, congenital heart disease is far more common. In fact, heart defects are the most common type of birth defect: About one in 100 babies is born with one.
But with advances in medical care and treatments, such as fetal diagnosis and neonatal surgeries, many of those children are living longer. More than 90% of children born with a congenital heart defect (CHD) now live to at least age 18. It’s estimated that the number of adults living with CHDs—about 1.4 million—is roughly the same as the number of children living with CHD, although there is no US system to track CHDs beyond early childhood). Even babies with critical CHDs have better chances of survival now: Between 1979 and 1993, about 67% survived to one year; that number rose to about 83% between 1994 and 2005.CDC
Nonetheless, many children with CHDs will require additional operations and/or medications as adults, and they often face a life-long risk of health problems, such as heart failure and stroke. Moreover, they’re now living long enough to develop high blood pressure, obesity, and other “adult” conditions.
Most CHDs are thought to be caused by a combination of genes and other risk factors, such as environmental exposures and maternal health. Researchers have, for example, linked maternal diabetes to an increased risk of CHD. But there has also been a rise in acquired, preventable heart disease that is attributable to the rise in childhood obesity and type-2 diabetes. According to the CDC, the percentage of children who are obese has tripled since the 1970s. Today, a fifth of teens, ages 12 to 19, are obese.
As the nation as a whole trends toward metabolic syndrome, it’s not surprising that children are facing the same constellation of risk factors. That’s why researchers are not only focusing on what causes the heart disease, but how to manage the risk factors and predict the sequelae.