Using the technique of intravascular ultrasound (IVUS) in hearts removed for transplantation from accident victiims of all ages in the US, investigators at the Cleveland Clinic found advanced atheroscerotic plaque in one sixth of teenagers. By age 50, 85% of hearts had advanced plaque. None of these subjects had symptoms or had yet had a heart attack but were clearly at risk for one because the plaque was buried in the arterial wall which had undergone compensatory dilation. Obviously prevention of atherosclerosis must begin in childhood. Unless one is foolish enough to believe that statins should be given to every child in the Western world, prevention means adoption of a non-atherogenic lifestyle from weaning.
