Köchli S, et al. - In this cross-sectional study, researchers examined how obesity, hypertension, and physical fitness impact retinal microvascular health and large artery stiffness in children. Using standardized procedures for children, screening for central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) diameters, pulse wave velocity (PWV), body mass index, blood pressure (BP), and cardiorespiratory fitness was done in 1,171 primary school children (aged 7.2±0.4 years). The reference values of the population-based German KiGGS study and the American Academy of Pediatrics guidelines were used to categorize BP. In young children, associations of childhood obesity and hypertension, even at preclinical stages, with microvascular and macrovascular impairments were evident. In order to counteract development of small and large vessel disease early in life, primary prevention programs targeting physical activity behavior may be of help.