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January 29th, 2009
10:37 AM ET

Should children take cholesterol reducing drugs?

As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta.

Asked by Kate, Cherry Hill, New Jersey

"My 10-year-old is overweight and our doctor suggested he start taking statins. Is he too young to begin this type of medication? Is it even safe?"

Answer:

Strange as it sounds, in rare cases prescribing statins to kids as young as 8-years-old is recommended by the American Academy of Pediatrics.

But certainly, not every child who is overweight needs such treatment.

The academy recommends that doctors use the following criteria when prescribing statins to kids: a child’s LDL level above 160 plus two risk factors, such as being overweight and high blood pressure. Or a child with no risk factors but an LDL level above 190.

Although controversial to some, many experts agree that these cholesterol-lowering drugs are safe, and the benefits outweigh any potential side effects.

The American Academy of Pediatrics looks at it as a preventive measure, hoping to avoid serious health problems later in life. The U.S. has a generation of children developing adult-like health conditions that will put them at high risk for blood clots and heart disease by their mid-30s if parents and doctors don’t monitor it.

That’s one reason, with an estimated one in three of our kids overweight, pediatricians are beginning to track weight and cholesterol levels starting at age 2.

But is medication the only answer? Absolutely not. Parents first need to exhaust all diet and exercise options. Take walks at night or race around the living room to burn extra calories each day. And lead by example. If you make healthy food choices, your kids will pick those habits as well. Small changes can save kids from years of potential health problems. For an overweight child, losing just 5 percent of their body weight can reduce cholesterol levels and prevent the need for medication.


soundoff (13 Responses)
  1. Bonnie MA, MPH, CNS, LDN

    Dr. Gupta is absolutely correct about being the last resort (and a distant one at that). Before a parent would ever consider a statin, they should also rule out inflammation as being the culprit. Cholesterol is only a piece of the pie when assessing cardiac health.

    February 2, 2009 at 10:48 | Report abuse | Reply
  2. sean brizendine

    sounds to me like the pharmaceutical industry is getting ready to cut a deal with the american medical association.

    "sean in santa rosa"

    February 3, 2009 at 13:16 | Report abuse | Reply
  3. Terry

    While I agree that something should be done about elevated cholesterol levels in children, medication should definately be a last resort. I have two concerns, one would be that alot of medications have no studies on their long term effects in children, and what about side effects and how they would manifest themselves in a child.

    February 3, 2009 at 16:21 | Report abuse | Reply
  4. Dr. Ed

    The bigger question is what do you do if exercise, weight loss and diet fail? Is it better to be overweight with normal cholesterol on long term medications or is it better to be overweight with high colesterol and a failed exercise plan?

    February 5, 2009 at 14:10 | Report abuse | Reply
  5. Nicole

    It should be noted that there are genetic disorders, such as familial hypercholesterolemia, that cause people to have high cholesterol even in childhood, which generally does not respond to diet and exercise alone and which can lead to heart disease very early in adult life. While this is not the case for every child with elevated LDL, it is not that rare either (estimated incidence 1:500 people). I have this disorder and have been on drug treatment, either statins or earlier drugs like Cholestid, since childhood, with no long term side effects. Drugs like statins have been a godsend to families like mine, in which people used to die of heart attacks in their 30s and 40s, before these drugs were developed. Please do not make the mistake of thinking that this is all about the drug companies making money or people being too lazy to eat right or exercise. Each case needs to be evaluated in its own context, including family history.

    February 10, 2009 at 12:04 | Report abuse | Reply
  6. billy

    The best way to reduce high ldl levels is not by taking extra medications as it will strain the kidneys and liver but by working out and getting the body's skeletal system to start burning that fat as an energy source
    so watch little piggy dont take the lazy mans way out and chomp on pills get up and exercise

    February 11, 2009 at 21:28 | Report abuse | Reply
  7. Ken

    Statins should be a last resort only. Unfortunately, given our American culture, we are basically calling out for a last resort because we are a culture incapable of self-discipline. Obesity numbers are rising geometrically and are already costing children major quality of life problems, let alone the dozens (hundreds in indirect costs)of billions of dollars it's costing the adult population. Statins are not the final answer. But we need something to stem the tide.

    February 12, 2009 at 12:40 | Report abuse | Reply
  8. Glen

    These drugs destroy a lot of adult lives and they want to give them to children ? Safe ???? I don't thinks so . I know I'm one of those adults whose lives it has ruined.

    February 12, 2009 at 13:32 | Report abuse | Reply
  9. Kayla

    Yikes - by all means, change that kids diet. This is an epidemic, obesity and now cholesterol? What ever happened to parenting? The parents should be responsible for this problem - in some ways I consider this abuse.

    March 10, 2009 at 16:23 | Report abuse | Reply
  10. Matt

    Nicole, the funny thing is that you've just bought into the lie that statin drugs lower your risk of heart disease. You can even check the ads of any major statin. Crestor, for instance, clearly states that it had never been shown to reduce the risk of heart attack or heart disease. So, essentially one can die of a heart attack with low cholesterol or they can die with high cholesterol, either way they're still dead. Also, the rule of genetics has essentially been abolished in science. No one is a slave to their parent's genes. That hypothesis comes from old, old "science". Considering putting kids on a drug that has basically no purpose other than to make money and give people a false sense of security is criminal. We will never solve the healthcare problems of this country by taking a chemical substance from the outside and putting it into a biological body. That is a contradiction. Everyone who has bought into the high cholesterol lie should read up on what cholesterol is and why your body needs it to survive. The drug companies keep lowering and lowering what is considered "normal" cholesterol. I don't think I need to point out why. Do your own research before you listen to anyone's opinions (mine included). If we all took control of our own health rather than blindly following pharmaceutical-sales-rep-educated doctors then maybe things would change.

    July 30, 2009 at 08:11 | Report abuse | Reply
  11. foods high in cholesterol

    Arn't our kids exposed to too many drugs already. There are so many ways to lower cholesterol but just eating the right foods and avoiding the saturated fats.
    More drugs are never a good replacement for a good healthy diet and lifestyle.
    Check out http://www.foodshighincholesterol.info to find out more.

    August 14, 2009 at 04:45 | Report abuse | Reply
  12. Barkeater

    I have had lifelong high cholesterol, diagnosed as familial hypercholesterolemia (FH). My now 22 year old son has FH too.
    I would almost never give statins to a child. The one case might be if there is a powerful family history of fatal heart attacks before age 50. Otherwise, the risk posed by high LDL is not that great, no matter how high it is. By itself, it probably doubles the risk compared to a person who has normal cholesterol (my 240 mg/dl LDL (yikes!) gives me an 8% risk of a heart attack in the next ten years, according to the medical establishment). For people who have not yet had heart disease (primary prevention), statin drugs may lower the risk by 30%, perhaps. Statins cause side effects, and those are much more common than you think (including in my case depression, after 8 years on the drug, which ended 3 years later within days of quitting the drug; bad joint pain went away too). Rather than a statin, find other ways to reduce heart risk (don't be content with 30% reduction, either). Limit or eliminate wheat and sugar, including fructose. Get Vitamin D levels up high (see Dr. William Davis's heart scan blog). Reduce Omega 6 fats, add Omega 3 (daily fish oil supplement). Get nutrition in order (examine your diet - it is likely you do not get adequate magnesium, selenium, and iodine). Correct thyroid function. Attack obesity as a disease and not a character flaw (see Gary Taubes book, Good Calories, Bad Calories). Transfats are bad, but saturated fat and dietary cholesterol are not in any way the problem they are made out to be. Bottom line – doctors push statins as the first treatment, and oversell their "benefit" and pay no attention to the $1,200 per year cost, when other things that cost little and have only positive side effects (Vitamin D supplementation, up to say 8000 iu per day) have greater benefit at minimal cost (12 cents per day). Giving a child a statin is a risky proposition, and almost never would the reward outweigh the risk unless the risk is incredibly extreme. For heart attack prevention, don't take my word for it - read the Davis Heart Blog.

    January 19, 2010 at 09:55 | Report abuse | Reply
  13. FH Foundation

    High cholesterol is of course a consequence of poor diet behavior and exercise, but the genetics and family history will always play a role in heart disease risk. Children should be treated for High LDL's if it turns out there is a family history of heart disease. Familial Hypercholesterolemia is a condition in which an early-age treatment could be helpful. As a non-profit foundation, we try to raise awareness for hypercholesterolemia. http://www.thefhfoundation.org

    November 26, 2012 at 17:44 | Report abuse | Reply

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.