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The American Academy of Pediatrics recommends cholesterol meds for children under 10


The Villi Phanatic

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Below is a brief press release from the AAP website in regards to their recommendations and treatment guidelines for cholesterol.

from http://www.aap.org/advocacy/releases/july08lipidscreening.htm

"For Release: July 7, 2008, 12:01 am (ET)

The American Academy of Pediatrics has issued new cholesterol screening and treatment recommendations for children. The policy statement, “Lipid Screening and Cardiovascular Health in Childhood,” recommends cholesterol screening of children and adolescents with a family history of high cholesterol or heart disease. It also recommends screening patients whose family history is unknown or those who have other factors for heart disease including obesity, high blood pressure or diabetes. Screening should take place after age two, but no later than age 10. The best method for testing is a fasting lipid profile. If a child has values within the normal range, testing should be repeated in three to five years. For children who are more than eight years old and who have high LDL concentrations, cholesterol-reducing medications should be considered. Younger patients with elevated cholesterol readings should focus on weight reduction and increased activity while receiving nutritional counseling. The statement also recommends the use of reduced-fat dairy products, such as two percent milk, for children as young as one year of age for whom overweight or obesity is a concern."

There are tons of articles and commentary on this, and I just quickly grabbed one for reference. Below are some excerpts:

from http://www.latimes.com/features/health/medicine/la-sci-statin9-2008jul09,0,2660728.story

"Experts said... ...that under the guidelines, fewer than 1% of children would be considered for statins.

Children with these extremely high LDL levels are known to have an increased risk of heart disease later in life.

But some doctors predicted that the guidelines would lead to the use of drugs in children with only moderately high cholesterol levels.

"There may be some pressure to start them on drugs to make these numbers better," said Dr. Thomas B. Newman, an epidemiologist and pediatrician at UC San Francisco. He also worries that the acceptance of drug use would shift the focus of treatment away from diet and exercise.

The guidelines, produced by a seven-member panel and published in the academy's journal, Pediatrics, did not include any disclosures about the authors' ties to drug makers.

One author, Dr. Stephen Daniels, a pediatrician at Cincinnati Children's Hospital, has acknowledged working as a consultant for Merck & Co., which markets statins, and Stettler said he had participated in industry-funded clinical trials of cholesterol drugs.

Dr. Jerold F. Lucey, editor of the journal, said that disclosures weren't required for academy-issued guidelines because the panels were already rigorously vetted."

...

"Most of the clinical trials involved teenagers. The authors of the guidelines settled on 8 as the minimum age for drug therapy because that was the age of the youngest patients in any clinical trial, Stettler said.

But the studies, the longest of which tracked children for four years, did not last long enough to show the long-term benefits of starting treatment earlier -- or the potential harms."

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