Koskinen JS, Kytö V, Juonala M, et al. - Given that atherosclerosis has roots in childhood and pediatric guidelines offer cut-off values for cardiovascular risk factors, researchers investigated if these cut-offs foretell adulthood advanced atherosclerosis. The initiation of the Cardiovascular Risk in Young Finns Study follow-up of children dates back to 1980 when 2,653 participants with data for the present analyses were aged 3–18 years. Carotid ultrasound data were also obtained, along with adulthood cardiovascular risk factors, in 2001 and 2007 follow-ups. The presence of carotid plaque was noted in 88 (3.3%) participants. When adjusted for age and gender, the relative risk for carotid plaque was estimated to be 3.03, 1.51, and 1.93 for childhood dyslipidemia, for childhood elevated systolic blood pressure, and for childhood smoking, respectively. In models additionally adjusted for adult risk factors and family history of coronary heart disease, the carotid plaque was independently predicted by childhood dyslipidemia and smoking. Childhood prevention efforts were strengthened by the findings. Also, guideline-based cut-offs were shown to have utility for recognizing children carrying an increased risk for adulthood atherosclerosis.