July 7th, 2008
05:09 PM ET

Does your 8-year-old need cholesterol drugs?

By Miriam Falco
CNN Medical Managing Editor

When my sister was about 15, she went on a diet that called for eating a lot of eggs.  I distinctly remember her coming home from the doctor and telling me she had the cholesterol level of a 50-year-old and had been told to eat a more balanced diet.

Things have changed since then.   When I was in school (back in the Dark Ages), there were maybe a couple of fat kids in my class.  Chubby kids are much more the norm nowadays.  According to the Centers for Disease Control and Prevention, over 17 percent of our nation’s children are either overweight or obese.

Seeing children with adult health problems is much more likely than in it was 20 years ago.  Today, new guidelines from the American Academy of Pediatrics seek to bring “a new urgency given the current epidemic of childhood obesity” because children are now at increased risk for type 2 diabetes, high blood pressure and heart disease – conditions adults used to get more regularly in their 50s.

This new AAP report says children 2 and older should get their cholesterol tested if they have a family history of heart disease or cholesterol problems (too much “bad” cholesterol and too little “good” cholesterol).

Children without a family history, but have other risk factors, such as being overweight or obese, have high blood pressure, are diabetic or smoke, should also be screened.  For more details on the report, go here.

What caught my eye is that that the AAP is suggesting patients as young as age 8 could be given cholesterol-lowering drugs.   This may seems shocking, but to be fair, the AAP is talking about children with LDL (“bad” cholesterol) levels at 190 or higher or over 160 if they have a family history of heart disease.  The goal is to get the bad cholesterol under 160.  Adults are supposed to keep their entire cholesterol levels under 200.

Dr. Nicolas Stettler, an assistant professor of pediatrics at Children’s Hospital of Philadelphia helped develop these new AAP guidelines.  He says studies have shown that statins are safe for children.  He also says, although the number of children genetically predisposed to having high cholesterol is still relatively small, it’s not rare.  Stettler points out that not every child with the genetic makeup that leads to high cholesterol is obese.  But if cholesterol screening shows a child has high levels of cholesterol and six months of lifestyle and diet changes can bring those numbers down, adding a statin is recommended.  “It’s not a simple decision and a lifetime commitment.”

Dr. Jackie Gotlieb, a spokesperson for “Kids Health First” – an alliance of 183 primary care pediatricians in 34 independent pediatric in Metro Atlanta called the new guidelines “very reasonable recommendations.”  

“These are recommendation pediatricians can live with.   Although side effects such as elevated liver enzymes and muscle problems can happen in children as well as adults, this is also something doctors can easily keep an eye on.”   

Has your child been screened for high cholesterol?  How would you feel if your child needs to take a cholesterol-lowering drug?

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