Hold that chicken finger. The American Academy of Pediatrics today issued a fresh policy statement on the management of high cholesterol in children. Bottom line: kids from families with a significant history of heart disease should be screened between the ages 2 and 10 years. Significant elevations in a child’s lipid profile should be managed with diet for 6-12 months and reevaluated. It is recommended that kids over age 8 years with persistent elevation in LDL cholesterol as defined by the AAP’s policy be considered for cholesterol lowering medications.
But before you get that warm, fuzzy feeling that we’ve got it all figured out, here’s what we don’t know:
Does elevated cholesterol in childhood predispose to later heart disease? There are no studies proving this to be the case although we assume what applies to us applies to our kids.
What’s the long-term safety profile of statin medications (one class of cholesterol lowering drug), for example? Short-term studies look good, long-term safety isn’t clear.
Will the long-term use of cholesterol lowering medications beginning in childhood prevent adult heart disease? We just don’t know.
While the pharmacologic management of the dangerously at-risk child is more clear cut, many kids fall into the fuzzy category. And when it comes to the long-term use of medications for what is a dietary problem in many cases, we approach what could be a very slippery slope for both parents and pediatricians.