Guidelines for Children’s Heart Health

Image for children's heart health articleCardiovascular disease includes conditions that affect the heart and blood vessels, such as atherosclerosis (clogging of the arteries), heart attack, stroke, and high blood pressure. While you may think that these conditions are more of a concern for adults, researchers are now highlighting how important it is to prevent cardiovascular disease from developing in children.

The National Heart, Lung, and Blood Institute (NHLBI) has developed guidelines to help promote heart health in children. It’s never too early to think about your child’s future! Learn how doctors can identify whether your child is at risk, what can be done to prevent cardiovascular problems, and which treatments can improve your child’s chances of becoming a healthy adult.

Is Your Child at Risk?

Based on the latest research, the NHLBI’s guidelines provide ways for doctors to assess the risk of cardiovascular disease in children. Recommended screenings include:

Screening NHLBI Recommendation
Blood pressure measurement annually beginning at age 3 years and then at every visit starting at age 18 years
Lipid profile (tests for cholesterol problems) once between ages 9-11 years and again between ages 17-21 years; measure at other times if child is at higher risk of developing cardiovascular disease due to family history of cardiovascular disease or child has diabetes, high blood pressure, or if the child is overweight
Body mass index (BMI) tracking started at age 2 years

Other important factors that the doctor will consider include whether your child has:

  • A history of exposure to secondhand smoke or has a personal history of smoking
  • A family history of cardiovascular disease
  • A sedentary lifestyle
  • A poor diet

By evaluating your child, the doctor can address conditions that are closely linked to cardiovascular problems, like obesity, high cholesterol, and high blood pressure.

What Are the Recommendations?

Focusing on the areas of nutrition, physical activity, and tobacco exposure, the NHLBI recommends prevention and treatment guidelines for children of all ages. You can play an integral role at home by:

  • Following the ChooseMyPlate dietary guidelines for children aged 2 years and older, which focuses on getting a proper balance of fruits, veggies, whole grains, protein, and dairy products
    • Note: If your child is at high risk for cardiovascular disease, the doctor will make additional recommendations, like eating a low-sodium and low-fat diet.
  • Showing your child the importance of being active by exercising and encouraging him or her to exercise, too
  • Putting limits on how much time your child is allowed to play video games, use computers, and watch TV
  • Doing fun activities together as a family such as playing ball or going for a hike
  • Having a safe area for your child to play outside
  • Making your home smoke-free—If you smoke, it is a good idea to quit
  • Talking to your child about the dangers of smoking—If your child smokes, work with the doctor to help your child find strategies to quit.

In addition to these lifestyle changes, the doctor may need to prescribe medication if your child is diagnosed with a condition like high blood pressure or high cholesterol. No matter what your child’s age or risk factors, there are ways to make each day healthier. Creating routines that focus on good nutrition, exercise, and healthy habits can help your child set the stage for a long life and a strong heart.


American Council on Exercise
National Heart Lung and Blood Institute


Canadian Cardiovascular Society
Heart and Stroke Foundation of Canada


Childhood obesity facts. Centers for Disease Control and Prevention website. Available at:
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Updated August 27, 2015. Accessed February 25, 2016.
Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. National Heart Lung and Blood Institute website. Available at:
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Published 2012. Accessed February 25, 2016.
NHLBI integrated guidelines for pediatric cardiovascular risk reduction. EBSCO DynaMed website. Available at:
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Updated February 12, 2013. Accessed February 25, 2016.
Last reviewed February 2016 by Michael Woods, MD
Last Updated: 5/6/2014

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