Review article - Special issue: Cardiovascular PreventionTwenty years of cardiovascular risk prevention in Czech children

Coronary heart disease is the leading cause of death in the Czech Republic. Pathological data have shown that atherosclerosis begins in childhood and that the extent of atherosclerosis in children can be correlated with the presence of cardiovascular risk factors such as: hypercholesterolemia, obesity, hypertension and cigarette smoking. Pediatric preventive program in the Czech Republic, which started in 1992, identifies children at high risk of atherosclerosis. At the age of 5 and 13 years, pediatricians are obliged to measure not only blood pressure and BMI, but also lipid profile (plasma total cholesterol, LDL, HDL cholesterol and triglycerides) in children with positive family history. This obligation is incorporated in the health certificate of everyone born in the Czech Republic. The lipoprotein profiling is also offered to other family members. Children identified as being at an increased risk of ischemic heart disease are referred to pediatric cardiologists or specialized centers to be followed up and treated. During the past two decades this strategy has promoted cardiovascular health for all children and contributed significantly to progress in the reduction of mortality for cardiovascular diseases in the Czech Republic.