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Canadian Journal of Cardiology

Cardiovascular Risk and Cardiovascular Health Behaviours in the Transition From Childhood to Adulthood

      Abstract

      The prevention and management of cardiovascular risk factors during the transition from childhood to adulthood is critically important in defining cardiovascular health trajectories. Unfortunately, many young people fall out of clinical care during this important time, leading to worsening cardiovascular risk and missed opportunities to modify future outcomes. The field of health care transition has evolved to support young people with complex health needs in developing self-management and self-advocacy skills to promote positive health outcomes despite changes in health care providers and resources. While transitional care efforts are largely focused on childhood-onset chronic illnesses such as sickle cell disease and cystic fibrosis, young people with cardiovascular risk factors such as hypertension, obesity, and dyslipidemia also stand to benefit from structured supports to ensure continuity in care and positive health behaviours. On the backdrop of the broader health care transition literature, we offer practical insights and suggestions for ensuring that young people with cardiovascular risk factors experience uninterrupted high-quality care and support as they enter the adult health care system. Starting transition preparation in early adolescence, actively engaging all key stakeholders throughout the process, and remaining mindful of the developmental underpinnings and social context of transition are keys to success.

      Résumé

      La prévention et la prise en charge des facteurs de risque cardiovasculaire durant la transition de l’enfance à l’âge adulte jouent un rôle crucial dans la définition des trajectoires en santé cardiovasculaire. Beaucoup de jeunes cessent malheureusement d’être suivis durant cette période importante, ce qui entraîne une aggravation du risque cardiovasculaire et des occasions manquées d’améliorer les résultats futurs. Le domaine de la transition des soins de santé a évolué afin d’aider les jeunes ayant des besoins complexes en matière de santé à acquérir les compétences nécessaires pour être autonomes et s’autoreprésenter, et ce, dans le but de favoriser l’obtention de résultats de santé positifs malgré les changements de fournisseurs et de ressources de soins de santé. Les initiatives de transition des soins visent principalement les patients atteints de maladies chroniques apparaissant durant l’enfance, comme la drépanocytose et la fibrose kystique, mais les jeunes présentant des facteurs de risque cardiovasculaire comme l’hypertension, l’obésité et la dyslipidémie pourraient aussi tirer des bienfaits de programmes structurés pour les aider à continuer de recevoir les soins dont ils ont besoin et à adopter des comportements favorisant la santé. Fondées sur l’ensemble des publications traitant de la transition des soins de santé, les observations et les suggestions pratiques présentées visent à s’assurer que les jeunes présentant des facteurs de risque cardiovasculaire continuent de recevoir des soins de qualité supérieure et de l’aide lorsqu’ils passent au système de soins de santé pour adultes. La réussite de la transition repose sur trois éléments : la préparation à la transition dès le début de l’adolescence, la mobilisation active des intervenants clés tout au long du processus et le souci des fondements du développement et du contexte social de la transition.
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