“The Child Is Father of the Man” (William Wordsworth,1802)⁎

The occurrence of atherosclerosis at an early age has long been the subject of curiosity and wonder. Isn’t it remarkable that 65 of 140 combat soldiers who died as a result of injuries sustained in World War I had increased coronary atherosclerotic plaques at a mean age of 27.7 years (1)? How interesting is it that grossly visible lesions not causing obstruction were present in 35% of 300 Korean War fatalities at an average of 22.1 years of age,with 39% having 10% to 90% stenosis,3% total occlusion,and only 23% free of grossly visible coronary lesions (2)! This curiosity quickly dissipates despite confirmation by subsequent landmark studies (3,4) and evidence that favorable risk factor profiles early in life are associated with better outcomes (5,6). Attention is quickly turned to the detection and treatment of atherosclerosis in adults,at which point our best efforts produce only a 30% reduction in events compared with placebo in the primary prevention population (7).
Journal of the American College of Cardiology Current Issue

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