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Guidelines for Children’s Heart Health

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Is Your Child at Risk? | What Are the Recommendations?

Image for children's heart health articleCardiovascular disease includes conditions that affect the heart and blood vessels, such as atherosclerosis (clogging of the arteries), heart attack, stroke, and high blood pressure. While you may think that these conditions are more of a concern for adults, researchers are now highlighting how important it is to prevent cardiovascular disease from developing in children.

The National Heart, Lung, and Blood Institute (NHLBI) has developed guidelines to help promote heart health in children. It’s never too early to think about your child’s future! Learn how doctors can identify whether your child is at risk, what can be done to prevent cardiovascular problems, and which treatments can improve your child’s chances of being a healthy adult.

Is Your Child at Risk?

Based on the latest research, the NHLBI’s guidelines provide ways for doctors to assess the risk of cardiovascular disease in children. Recommended screenings include:

ScreeningNHLBI Recommendation
Blood pressure measurementannually beginning at age three years and then at every visit starting at age 18 years
Lipid profile (tests for cholesterol problems)once between ages 9-11 years and again between ages 18-21 years; measure at other times if child is at higher risk of developing cardiovascular disease (eg, family history of cardiovascular disease or child has diabetes, high blood pressure, or is overweight)
Body mass index (BMI) tracking started at age two years

Other important factors that the doctor will consider include whether your child:

  • Has been exposed to secondhand smoke or has a personal history of smoking
  • Has a family history of cardiovascular disease
  • Has a sedentary lifestyle

By evaluating your child, the doctor can address conditions that are closely linked to cardiovascular problems, like obesity, high cholesterol, and high blood pressure.

What Are the Recommendations?

Focusing on the areas of nutrition, physical activity, and tobacco exposure, the NHLBI recommends prevention and treatment guidelines for children of all ages. You can play an integral role at home by:

  • Following the ChooseMyPlate dietary guidelines for children aged two years and older, which focuses on getting a proper balance of fruits, veggies, whole grains, protein, and dairy products
    • Note: If you child is at high risk for cardiovascular disease, the doctor will make additional recommendations, like eating a low-sodium and low-fat diet.
  • Showing your child the importance of being active by exercising and encouraging him to exercise, too
  • Putting limits on how much time your child is allowed to play video games, use computers, and watch TV
  • Doing fun activities together as a family (like playing ball, going for a hike)
  • Having a safe area for your child to play outside
  • Making your home smoke-free—If you smoke, it is a good idea to quit
  • Talking to your child about the dangers of smoking—If your child smokes, help him to find strategies to quit.

In addition to these lifestyle changes, the doctor may need to prescribe medicine if your child is diagnosed with a condition like high blood pressure or high cholesterol. No matter what your child’s age or risk factors, there are ways to make each day healthier. Creating routines that focus on good nutrition, exercise, and healthy habits—like not smoking—can help your child set the stage for a long life and a strong heart.


American Council on Exercise


National Heart Lung and Blood Institute



Canadian Cardiovascular Society


Heart and Stroke Foundation of Canada



Childhood obesity facts. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/healthyyouth/obesity/facts.htm. Updated June 7, 2012. Accessed June 18, 2012.

Cholesterol and atherosclerosis in children. American Heart Association website. Available at: http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Cholesterol-and-Atherosclerosis-in-Children_UCM_305952_Article.jsp. Updated June 20, 2012. Accessed June 18, 2012.

Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/guidelines/cvd_ped/summary.htm. Published 2012. Accessed June 18, 2012.

Food groups. Choose MyPlate.gov website. Available at:http://www.ebscohost.com/dynamed/. Accessed June 19, 2012.

NHLBI integrated guidelines for pediatric cardiovascular risk reduction. EBSCO DynaMed website. Available at:http://www.ebscohost.com/dynamed/. Updated February 28, 2012. Accessed June 18, 2012.

Last reviewed June 2012 by Brian Randall, MD and Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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