02/15/2026
Over the last two decades in pediatric cardiology, one pattern has become impossible to ignore.
We are saving more children with congenital heart disease than ever before.
Survival has improved. Outcomes are better. Lifespans are longer.
And yet, another trend is emerging alongside this progress.
More children and adolescents are developing acquired cardiovascular conditions earlier in life.
Not structural defects, but hypertension, inflammatory conditions, metabolic risk, and cardiac complications shaped by environment, lifestyle, and access to care.
In clinic, this shows up quietly:
• Adolescents with blood pressure that should not be elevated
• Young patients carrying metabolic risk years before adulthood
• Cardiac issues influenced as much by social and lifestyle factors as by biology
This is not a contradiction.
It is a transition.
Pediatric cardiology is no longer only about repairing hearts, it is increasingly about protecting them early enough to change the trajectory of adult disease.
What we do in childhood now determines cardiovascular health decades later.
That belief guides how I think about prevention, equity, and longevity.
Adult heart disease does not begin at forty or fifty.
It begins with patterns established much earlier.
The future of heart health will depend less on late interventions and more on how early we recognize risk, support families, and build systems that prioritize long-term cardiovascular resilience.
If we truly want to improve outcomes across the lifespan, pediatric heart health cannot sit on the sidelines of prevention, it has to be central to it.
Repost if you believe heart disease prevention should start in childhood.
