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Chapter 1 Introduction
  • Richard S Liu
Richard S Liu
Murdoch Childrens Research Institute
Author Profile


Preventative approaches for cardiovascular disease have had  a profound effect on reducing adult morbidity and mortality in the 20th century. Despite this, cardiovascular disease will remain one of the most  important health challenges in the 21st century. Prolonged exposure  to lifestyle and other types of risk factors make meaningful change in disease  risk difficult to achieve as adults, particularly after the successes in  cardiovascular mortality reduction since the 1970’s. New goals such as the World Heart Federation’s ‘25 by 25’  campaign[1] or the American Heart  Association’s 2020 Impact Goal[2]  represent a fundamental shift in global emphasis to primordial prevention and supporting the attainment of ideal health rather than treatment of disease risk.
Atherosclerosis, the main pathological mechanism in  cardiovascular disease, begins early in life. Compelling evidence for this already  exists in autopsy and imaging studies. It is also clear that exposure to risk  factors and behaviours such as dietary habits start in childhood and  adolescence, setting individuals on differing health trajectories later in life.
An understanding of early life risk factors, and their  immediate effects on atherosclerosis, provides insights into the natural origins  of cardiovascular disease and the potential effectiveness and appropriate timing  of interventions. Should the life-course model of health and disease prove  informative, earlier intervention, during periods of childhood plasticity, will  have lasting effects later in life. To realise these insights, investigation of  traditional and novel risk factors, and their relation to cardiovascular health trajectories, is required.

1.1 Research Plan

1.2 Chapter Summary