Don’t be surprised if your doctor recommends a cholesterol screening test for your 2 year old. Yes, what once was a common screening test for those over 35, is now becoming a way of detecting early risks for heart disease.

The research has shown through autopsy data that atherosclerosis begins in childhood and that elevated cholesterol levels in childhood is associated with an increased risk of cardiovascular disease in adulthood. Lipid levels rise rapidly in our earlier years and stabilize by age 5 to those similar to adolescents. Currently 35-45% of children are screened for cholesterol levels due to a positive family history of cardiovascular disease (Bauchner, H. Journal Watch Pediatrics and Adolescent Medicine, Vol.7, Number 9, 2008, p.68).

The American Academy of Pediatrics (AAP) has released new guidelines due to the rising incidence of obesity and type 2 diabetes in U.S. children. Besides the standard advice of restricting cholesterol and saturated fats and exercise, the new guidelines calls for wider screening, and cholesterol-lowering drugs to be considered in children.

There are several concerns with using these drugs (statins) in children.

First, we don’t know the long-term risks or benefits of these drugs (statins) in children.
Second, there may be concerns about aggressive cholesterol lowering. A recent study analyzing the aggressive lowering of blood sugar in type 2 diabetes was associated with increased mortality. Lets not experiment on our kids!

Last, if a child is treated with a drug, does it not “label” that child as having high cholesterol, which could have long-term implications and possibly raise a red flag for health insurers to deny coverage for a pre-existing condition.

I believe each practitioner needs to consider the concerns and preferences of patients and families when making decisions about the use of statins in children.

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