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Statin Drugs May Protect Children's Hearts

Cholesterol-Lowering Drugs May Be Safe for Use in Children at Risk

WebMD Health News

July 20, 2004 -- Children with an inherited form of high cholesterol that leads to early heart disease may benefit from taking cholesterol-lowering statin drugs, according to new research.

The study shows two years of statin therapy significantly reduced "bad" LDL cholesterol levels and reversed some of the plaque buildup of atherosclerosis, or hardening of the arteries, in children at risk for heart disease. The cholesterol-lowering medication had no apparent negative effects on the children's growth and sexual development.

Statins are a class of drugs that block the enzyme in the liver that is responsible for making cholesterol in the body, and the cholesterol-lowering drugs are commonly used in adults with high cholesterol. But the safety and effectiveness of these drugs have not been widely studied in children.

Researchers say familial hypercholesterolemia is an inherited condition that causes LDL "bad" cholesterol levels to be abnormally high from birth onward. The disorder affects about one in 500 people and frequently leads to atherosclerosis and premature heart disease.

The findings, published in the July 21 issue of The Journal of the American Medical Association, suggest that treating children who have familial hypercholesterolemia with statin drugs may help reduce their future risk of heart disease. But more studies are needed to look at the long-term effects of statin use among children.

Statins May Help Children Lower Cholesterol Levels

The study compared the effects of treating children with this condition with the statin Pravachol or a placebo for two years. The children, who ranged in age from 8 to 18, also followed a low-fat diet and were encouraged to exercise regularly.

Researchers found that children who took the statin experienced a 24% reduction in LDL cholesterol levels compared with a 0.3% reduction among those who took the placebo.

Children who took statins also showed a trend toward regression of their atherosclerosis, while those who took the placebo showed a trend toward progression of the artery disease.

Researchers found no differences in growth, sexual maturation, and hormone levels. Serious side effects from the drugs can occur, such as muscle breakdown and liver function abnormalities. These side effects can be detected in blood tests but were not seen in the children taking statins.

"This shows the increased arterial wall thickness found in children with familial hypercholesterolemia is reversible," write researcher Albert Wiegman, MD, PhD, of the University of Amsterdam, and colleagues. "Moreover, we extensively analyzed possible adverse events and untoward influences on growth and maturation of the children and none were observed, although some of our safety outcomes may have been underpowered."

Researchers say that although this study provides "the most extensive follow-up to date, data on even longer-term safety and efficacy of statin therapy in children are needed."

In an editorial that accompanies the study, Antonio Grotto Jr., MD, DPhil, of the Weill Medical College of Cornell University in New York City, says this study shows that drug therapy may be needed in most children with familial hypercholesterolemia.

"Appropriate targeting of lifestyle and drug therapies will optimize primary prevention in this group at demonstrated risk for early coronary disease," he writes.

SOURCE: Wiegman, A. The Journal of the American Medical Association, July 21, 2004; vol 292: pp 331-337.

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Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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