NONTRADITIONAL RISK-FACTORS FOR ATHEROSCLEROSIS IN HIGH-RISK CHILDREN

Non-traditional risk factors for atherosclerosis were examined in chil dren whose fathers suffered from myocardial infarction up to age 48. F actors examined were hyperinsulinemia, insulin resistance, lipoprotein (a) [Lp(a)], fibrinogen, cardiovascular hyperreactivity, and autonomic nervous system dysfunction. Hyperinsulinemia was present in five case s (9%) and hypoinsulinemia in two. Insulin output following glucose-lo ad was significantly higher in obese children compared with controls. There was an increase in Lp(a) alone in 14 cases (24%) and with low de nsity lipoprotein in 6 cases. Increased fibrinogen and positive correl ation with insulin abnormality was present in 29% (76% females) (P > 0 .02). Cardiac hyperreactivity (increased systolic blood pressure) was present in 9% and increased blood pressure and pulse rate in 17%. Holt er monitoring pattern was sympathetic in 39% and parasympathetic in 47 % of cases. Thus a number of non-traditional risk factors were found t o be higher than normal in a relatively large number of children at hi gh risk for atherosclerosis, with 25 children having more than three r isk factors.