Intervention is urgently needed for high-risk people to reverse the alarming and epidemic increases in diabetes, obesity and metabolic syndrome, particularly in young people.

More than 10 percent of preschool children between the ages of two and five were overweight in 2002 -- up from 7 percent in 1994, according to the American Heart Association's Heart Disease and Stroke Statistics - 2005 Update released Friday.

Since 1991, the prevalence of obesity among American adults has increased 75 percent.

Risk Factors Present Early in Life

Cardiovascular disease (CVD) -- still the nation's No. 1 killer -- claimed 927,448 American lives in 2002, reports the AHA. The update includes a new section on the metabolic syndrome (MetS) in adolescents that indicates that rates of controllable risk factors for cardiovascular diseases are increasing among America's young people.

Cardiovascular diseases include high blood pressure, coronary heart disease (heart attack and angina), congestive heart failure, stroke and congenital heart defects, among others. The update includes recently published data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES) showing that about 65 million Americans had high blood pressure in 2002, which represents a 30 percent increase over the previous survey from 1988-94.

"While heart attacks and stroke remain the leading causes of death in men and women, we see in the 2005 Update that many risk factors for these conditions are common, preventable and occur well before the onset of disease," said Christopher O'Donnell, M.D., associate director of the National Heart, Lung and Blood Institute's Framingham Heart Study, and chair of the American Heart Association's statistics committee.

"These risk factors, including abnormal blood lipids and high blood pressure, often present early in life even before middle age, when preventative measures might make a large difference," Dr. O'Donnell says.

Metabolic Syndrome in Adolescents

About 1 million 12-19-year-olds in the United States (or 4.2 percent overall) have MetS. Many controllable risk factors for heart disease are encompassed in the metabolic syndrome: abnormal blood lipids, high glucose (blood sugar), high blood pressure and overweight/obesity. MetS during adolescence was defined in the 1988-1994 NHANES data as three or more of these abnormalities:

• Blood triglyceride level of 110 milligrams per deciliter (mg/dL) or higher.

• High-density lipoprotein (HDL, the "good" cholesterol) levels of 40 mg/dL or lower.

• Elevated fasting glucose of 110 mg/dL or higher.

• Blood pressure above the 90th percentile for age, sex and height.

• Waist circumference at or above the 90th percentile for age and sex.

The most common risk factor found in adolescents with MetS is being overweight. Not all overweight adolescents will have MetS, which was present in just under 30 percent of overweight adolescents. However, of those with MetS, nearly two-thirds were overweight.

Overweight in this age group means that body mass index (BMI), a measure of body fatness, was at or above the 95th percentile according to the Centers for Disease Control growth charts for children of similar age and sex.

Epidemic Increases

"Childhood risk factors carry over into adulthood, and may eventually translate into heart disease and other medical problems, such as diabetes. Obesity is a major risk factor for heart disease that should be controlled early in life," said Robert H. Eckel, M.D., an endocrinologist at the University of Colorado Health Science Center, Division of Endocrinology, Metabolism and Diabetes, and president-elect of the American Heart Association.

"Intervention is urgently needed for high-risk people to reverse the alarming and epidemic increases in diabetes, obesity and metabolic syndrome, particularly in young people," Dr. O'Donnell warned.