Challenges in Implementing Cardiovascular Risk Scores for Assessment of Young People With Childhood-Onset Autoimmune Rheumatic Conditions

Cardio-vascular risk (CVR) stratification tools have been implemented in clinical practice to guide management decision for primary prevention of cardiovascular disease. Less is known about how we can optimally estimate the CVR in children and adolescents or about the reliability of the risk stratification tools validated in adult populations. Chronic inflammation associated with autoimmune rheumatic disease (ARD) drives an increased risk for accelerated atherosclerosis in patients of all ages. Although the research is less advanced than in adult populations, it is recognized that young people with ARDs with childhood-onset have increased CVR compared to age-matched healthy controls, as supported by studies investigating lipid biomarker profile and markers of endothelial dysfunction. Further research is needed to address the unmet need for adequate CVR identification and management strategies in young people in general, and in those with underlying chronic inflammation in particular. This perspective paper explores various challenges in adequately identifying and managing CVR in younger populations and potential directions for future research.

Automated summary

Cardiovascular risk stratification tools are important in clinical practice for managing primary prevention of cardiovascular disease. However, there is limited knowledge about how to accurately estimate cardiovascular risk in children and adolescents, as well as the reliability of the risk stratification tools validated in adult populations. Chronic inflammation associated with autoimmune rheumatic disease increases the risk of atherosclerosis in patients of all ages. Young people with childhood-onset autoimmune rheumatic diseases have a higher cardiovascular risk compared to healthy controls of the same age. Further research is needed to address the need for accurate identification and management of cardiovascular risk in young people, especially those with underlying chronic inflammation.