Heart Association Backs Statin Use for At-Risk Kids

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Among the recommendations in the statement:

• In addition to checking family history in overweight and obese children, doctors should do screening with a fasting lipid profile.
• Overweight and obese children with lipid abnormalities should be screened for other aspects of metabolic syndrome, a condition characterized by a group of specific risk factors, such as excess weight, high blood pressure, elevated triglycerides, low levels of HDL "good" cholesterol and high fasting glucose levels.
• Lifestyle changes should be recommended for most children. But, if needed, a statin (started at the lowest dose) is recommended as the first line of treatment for children who meet criteria for starting lipid-lowering drug therapy, if there are no contraindications.
• For children with high-risk lipid abnormalities, the presence of additional risk factors or high-risk conditions may also lower the recommended levels of LDL "bad" cholesterol at which drug therapy should be started and lower the desired maintained target levels of LDL cholesterol. These high risks may include: male gender; strong family history of premature cardiovascular disease or events; presence of associated low HDL; high triglycerides; small dense LDL; presence of overweight or obesity and aspects of the metabolic syndrome; and the presence of other medical conditions associated with increased risk of atherosclerosis.

The statement also offers advice on monitoring children with lipid abnormalities as they grow, including keeping track of height, weight, body mass index, onset of puberty, and checking fasting lipoprotein profile every six to 12 months.

More information

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The Nemours Foundation has more about children and cholesterol.

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-- Robert Preidt