Precursors of Atherosclerosis in a Random Sample from a Hellenic Population: The Athens Study

Abstract

Background: Atheromatosis, the principal lesion in atherosclerotic cardiovascular disease, is associated with increased levels of blood pressure, serum cholesterol, cigarette smoking and other variables. As these lesions are thought to appear first in childhood, this study was designed to assess the levels of these atherosclerotic precursors in children living in Athens, Greece. Methods: The following parameters were measured in a random sample of 411 7 school children aged 6-18 years, living in the centre of Athens: body mass index, blood pressure, serum lipids, glucose, uric acid, calcium, phosphorus, creatinine, and haematocrit.Results: Mean levels of blood pressure, total cholesterol, cigarette smoking and body mass index increased with age in both sexes, levels being similar to those of children in developed countries. Smoking started at elementary school, and by puberty had reached adult levels. High levels of systolic blood pressure (21 30 mmHg) and total cholesterol (25.68 mmol/l) were seen in 22% and 13% of children respectively. Triglyceride and glucose levels did not increase with age; high-density lipoprotein cholesterol decreased and uric acid increased from 14 to 18 years, but only in boys.Levels of body mass index, total cholesterol, triglycerides, high-density lipoprotein and uric acid above the mean population values were found in 25% of children, and glucose levels above the mean in 500/0. Multiple linear regression analysis showed a positive correlation between systolic blood pressure and age, body mass index, uric acid, sex, glucose, triglycerides and high-density lipoprotein cholesterol (in that order), and between diastolic blood pressure and age, body mass index and trig1 ycerides. Conclusions:These findings indicate that the levels and prevalence of precursors of atherosclerosis are higher than expected in a southern European population, and are similar to those found in developed countries. This would indicate a need for greater awareness among the Greek population of preventive measures against developing cardiovascular disease.Journal of Cardiovascular Risk 1995, 2:525-531

Diet, blood lipid profile and physical activity patterns in primary school children from a semi‐rural area of Greece

“…Mean BMI (20.4 ± 3.5 kg m )2 ) and the prevalence of overweight (30%) and obesity (7%) in Volos children were quite high, similar to or even greater than those reported previously for young adolescent populations living in other areas of Greece, whether urban or rural (Adamopoulos et al, 1995;Mamalakis & Kafatos, 1996;Mamalakis et al, 2000;Krassas et al, 2001a,b;Karayiannis et al, 2003;Magkos et al, 2005). Nevertheless, a note should be made of the fact that overweight and obesity prevalence rates reported in the other studies of Greek children and adolescents are not all based on the IOTF criteria.…”

“…Likewise, such an activity pattern has been associated with a more favourable cardiovascular and metabolic risk profile among children 9-18 years old (Katzmarzyk et al, 1999). Despite the fact that children of the present study devoted more time on MVPA and less time on TV/ PC compared to their peers living in other Greek regions, still, they displayed similar or increased prevalence of overweight and obesity (Adamopoulos et al, 1995;Mamalakis & Kafatos, 1996;Mamalakis et al, 2000;Krassas et al, 2001a,b;Karayiannis et al, 2003;Magkos et al, 2005), and exhibited a worse blood lipid profile (Aravanis et al, 1988;Petridou et al, 1995;Schulpis & Karikas, 1998;Mamalakis et al, 2001;Ferro-Luzzi et al, 2002;Manios et al, 2002;Magkos et al, 2005). The reasons for this are unclear at present, and illustrate the need to study this population using a larger sample to confirm and further investigate the present intriguing findings.…”

“…Indeed, although the age-adjusted allcause mortality has gradually and steadily decreased, CVD mortality has increased (Chimonas, 2001). This higher prevalence seems to be related to overall lifestyle modifications, such as adverse dietary practices and physical inactivity (Kafatos et al, 1981(Kafatos et al, ,1997Adamopoulos et al, 1995;Voukiklaris et al, 1996). The documented concerning trends towards a progressively more unfavourable cardiovascular risk profile in younger age groups in Greece (Magkos et al, 2005) may result in multiple-fold increased CVD morbidity and mortality, as high-risk adolescents are likely to become high-risk adults (Chu et al, 1998;Dietz, 1998).…”

Obesity and associated cardiovascular risk factors among schoolchildren in Greece: a cross-sectional study and review of the literature

“…In Greece, previous studies in children and adolescents have suggested an especially high prevalence of elevated BP with rates even in the range of 20 % -30 % in the studied populations (9,21,72,73) . However, these results should be interpreted with caution, since confi rmation of hypertension requires repeated BP measurements in multiple visits, a fact that is probably responsible for overestimation of hypertension rates (39,65,67,74) .…”