Children's Cardiovascular Health Clinic

Heart Smart

Children at risk for heart disease find a champion at Scott & White

It's a parent's worst nightmare, watching as your child suffers through a debilitating disease, helpless and unable to fight back. Would it make it less difficult if that child were 40 years old instead of eight years old? And what would you do if you knew you could prevent future problems by changing the way you raised that 8-year-old?

For Catherine McNeal, M.D., Ph.D., a physician-researcher at Scott & White, the fight against the number one killer in the nation starts with our children. She's made it her mission to make sure children turn into healthy adults. As part of the Children's Cardiovascular Health Clinic (CCHC) at Scott & White, Dr. McNeal is dedicated to finding children who are at risk for developing cardiovascular disease and treating them before it starts.

"The goal of our clinic is to prevent or delay the onset of heart disease in adolescents," Dr. McNeal said. "Through the years, we have seen patterns of heart disease passed down through the generations. We are seeing that if we can find these children who are at risk for future problems and treat them early, we are giving them an advantage in the fight against cardiovascular disease."

To help further research, the CCHC has been given a grant from the American Heart Association to develop new protocols for diagnosing and treating children with cardiovascular risk factors, which include high cholesterol and a family history of heart disease, among others.

"Through our research, we are trying to find how we can diagnose these children in an asymptomatic stage when they are showing preliminary changes associated with cardiovascular disease," Dr. McNeal said. "We want to learn how we can protect them to prevent the progression of the disease to a symptomatic state."

Through the clinic, Dr. McNeal and her team are trying to recruit patients to take part in a research study, not only to help improve their health, but also to teach the physicians and healthcare professionals what does and doesn't work in treating children at risk for heart disease.

"Not only are we teaching these children and their families, but they are teaching us. We are learning how to better treat and diagnose them early so we can help them avoid serious problems in the future."

According to Dr. McNeal, there are two ways to develop cardiovascular disease (a buildup of cholesterol in any part of the body): inherited disorders, including high cholesterol; and developed risk factors, including obesity, tobacco use, diabetes, high blood pressure and physical inactivity.

"We see a number of children in our clinic who have a family member, most often mother or father, who has had a heart attack or heart surgery," Dr. McNeal said. "When we evaluate them, we sometimes find that they have high cholesterol, which means they might develop cardiovascular problems in adulthood."

And while some patients Dr. McNeal is working with have hereditary factors that could contribute to future problems, she says she is seeing more and more patients come through her doors with problems that have nothing to do with their family history. "Obesity is reaching epidemic proportions in this country, and it's taking a toll on our children," she said. "Too many children are becoming less active and eating high-fat diets, and that combination can lead to serious problems as they get older."

The clinic not only helps diagnose health problems, but also helps the parents and children become aware of potential dangers and helps guide them into a new, healthier lifestyle. Patients in the clinic are treated by a team made up not only of the physician, but of dietitians, exercise specialists and pharmacists.

"We have one of the few clinics in the nation devoted to this type of cardiac risk prevention," said Don Wilson, M.D., chairman of the Department of Pediatrics at Scott & White, who is also involved with the CCHC. "We have been working with national experts to develop strategies and identify and effectively treat children at risk for subsequent heart disease. And through our work, we have seen significant reductions in the cholesterol levels in many of our patients."

When the children come to the clinic, they are initially treated by changes to their diet. If no significant improvement in the cholesterol level is seen in six months, medication is considered to help lower the levels.

And for Dr. McNeal, treatment for these children is not a one-time thing. "We are in this fight for the long run," she said. "We will be with these children and their parents the whole way. We're not looking for or offering quick fixes. We are here to offer help and support to help these at-risk kids lead healthy lives and to be able to pass on their knowledge to their own kids. And we're also here to learn from them so we can help even more children in the future."

With the help of the AHA grant, physicians in the CCHC are hoping to turn generations of kids from potential heart attack victims into healthy adults.

To Participate In the Study:

Dr. McNeal and her team are looking for subjects for the research study. To be eligible for the study, children must be 10 to 18 years of age and have high cholesterol. The subjects are given either a cholesterol-lowering medication or a placebo (a pill that resembles the actual medication but does not contain any cholesterol-fighting agents) and are evaluated in nine visits over a period of 15 months. Anyone interested in learning more can call Lydia Clipper at 254-724-6750, or can e-mail lclipper@swmail.sw.org.

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