Kids & Cholesterol: Call for Early Action
Researchers Want Cholesterol-Lowering Drugs and Diet to Begin in Childhood
Young Children and Statins continued...
Daniels, who is chairman of the department of pediatrics at the University of Colorado, Denver School of Medicine, was a principal author of the revised AAP guidelines. He is also a spokesman for the American Heart Association.
Daniels says only a tiny percentage of children have LDL levels high enough to make drug treatment an option, but he agrees that earlier treatment could have long-term benefits.
"Pediatricians and family physicians should be aware that atherosclerosis can begin very early in life leading to heart disease much earlier in adulthood," he says. "Early lifestyle interventions, and possibly drugs, can reduce this risk."
Cholesterol-Lowering Strategy for Kids
In their analysis, Steinberg and University of California, San Diego colleagues Christopher K. Glass, MD, PhD, and Joseph L. Witztum, MD, call for more aggressive cholesterol-lowering strategies for both children and young adults.
Current guidelines call for adults with high risk for heart attacks and other cardiac events to strive for an LDL level of 70 mg/dL or below, but the three researchers argue that 50 mg/dL or below may be a more appropriate target.
"That goal is currently attainable in many patients with the treatment regimens now available, which include statins alone or in combination with other [cholesterol-lowering] drugs," they write.
With regard to lifestyle interventions, the researchers advocate a diet low in saturated fat and cholesterol for everyone, including babies as young as 7 months.
Until last month, the AAP recommended that children between the ages of 1 and 2 drink only whole milk, but the new guidelines do not include this recommendation.
"The idea was to give pediatricians a little more flexibility," Daniels says. "Recommending whole milk should be a judgment call based on considerations like family [heart disease] history and obesity."