The day after the American Academy of Pediatrics recommended prescribing cholesterol-lowering drugs to some 8-year-olds, howls of protest arose from many doctors and parents. While the academy maintains that prescription drugs could help cope with the rising tide of childhood obesity and could prevent children from developing heart disease later in life, many observers say the guidelines send the wrong messages to families.
Some doctors said the recommendation would distract from common-sense changes in diet and exercise, which are also part of the new guidelines. “To be frank, I’m embarrassed for the A.A.P. today,” said Dr. Lawrence Rosen [The New York Times]. Childhood obesity expert David Ludwig adds: “My concern is what this is saying about society when we are so quick to prescribe drugs for these conditions before having systematically attacked the problem from the public health perspective” [The New York Times].
The academy wasn’t beset from all sides; several pediatricians noted that the guidelines recommend prescribing statins, the cholesterol-lowering drugs, only to those children with the highest cholesterol and the worst family history of heart disease. Academy member Janet Silverstein also explained that the damage done to kids’ hearts could be irreversible; she cites long-term studies that showed heart disease developed over a lifetime. “We learned that even if, at the age 25, they decided to change their ways and lead the perfect life — cardiac events were predicted by their health in adolescence” [ABC News].
But still other doctors say that it’s irresponsible to prescribe drugs to children before conducting thorough studies to be sure it’s safe. Pediatrician says that statins are great for treating adults with high cholesterol, but that he has serious reservations about prescribing them to children. “The short-term safety studies in children are very reassuring, but what we don’t know and need to study is whether statins have unique long-term effects on developing organisms. We don’t know about that yet. The statin trials have been too short to say one way or the other. That’s why we have to be cautious about translating their broad use” [Newsweek], says Belamarich. He also points to some data suggesting that statins can interfere with developing embryos, and says that doctors shouldn’t prescribe the drugs to adolescent girls who might become pregnant.
Image: iStockphoto
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