Background: Atherosclerotic disease begins in childhood with the formation of the fatty streak. Atherosclerotic plaques form at the sites of the fatty streaks. There are no known risk factors to play a role in fatty streak formation. Since some people develop plaque at a young age and others do not develop plaque till an old age, it is clear that the key event in plaque formation must be what happens to the fatty streak. Risk factors for atherosclerotic disease are well known. The purpose of this paper is to demonstrate that the various atherosclerotic disease risk factors can be found in childhood. Materials and Methods: The author has reviewed his database of risk factors in those patients aged 19 years or less. The results are reported in this paper. Results: Lipid abnormalities occur earlier in life than do abnormalities of the other atherothrombotic disease (ATD, or atherosclerotic disease), with emphasis on the thrombosis that so often precipitates the acute cardiovascular event. Other ATD risk factors are mostly absent or minimally present in childhood and adolescence. Conclusion: The author has demonstrated that risk factors, mainly lipid risk factors, occur in childhood and adolescence. Given the high prevalence of ATD in adult life, the author advocates screening for ATD risk factors in persons aged 19 years or less.
