The American Academy of Pediatrics has issued new guidelines that call for testing at-risk children’s cholesterol levels from the age of 2, and advise giving some children cholesterol-lowering drugs from the age of 8 in hopes of preventing heart disease later in life. Writing in the journal Pediatrics, doctors say that the recommendations have taken on “a new urgency, given the current epidemic of childhood obesity.”
The new guidelines are likely to stir the controversy over prescribing long-term medications to children, especially for treating symptoms related to obesity, which can also be treated with diet and exercise. But proponents say there is growing evidence that the first signs of heart disease show up in childhood, and with 30 percent of the nation’s children overweight or obese, many doctors fear that a rash of early heart attacks and diabetes is on the horizon as these children grow up [The New York Times].
The academy doesn’t suggest that every single child should be tested at the age of 2, but most would be included in the overlapping risk groups. Those who already show signs of obesity should be tested, and the academy advises cholesterol screening of children and adolescents with a family history of high cholesterol or heart disease. The recommendation also includes patients whose family history is unknown or who have risk factors for heart disease, including obesity, high blood pressure, cigarette smoking or diabetes [Baltimore Sun]. If a child’s cholesterol levels are normal, the guidelines say the child wouldn’t have to be tested again for three to five years.
Children whose tests show high levels of “bad” cholesterol should be given nutrition counseling and advised to get more exercise, but doctors should also consider prescribing cholesterol-lowering drugs called statins to children age 2 or older, the guidelines say. However, the academy gives no advice on how long the children should maintain the drug treatment.
Many pediatricians greeted the guidelines as a positive development, including Dr. Jennifer Li, a Duke University children’s heart specialist. “We need to do something to stem the tide of childhood obesity,” Li said. Li said that 15 years ago most of her patients with cholesterol problems had an inherited form of cholesterol disease not connected to obesity. “But now they’re really outnumbered” by overweight kids with cholesterol problems and high blood pressure, she said [AP].