Important followup to Pediatrics cholesterol screening study: kids cholesterol may drop naturally

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The winding stream of science.

Last week the journal Pediatrics published a study promoting universal cholesterol screening for kids. This week’s Pediatrics publishes a study with a quite different perspective.

Reuters Health reports:

Very high cholesterol levels in kids may decline over time even without intervention, researchers from the U.S. Centers for Disease Control and Prevention (CDC) have found.

The findings add to an ongoing debate over the importance of high cholesterol in children, and whether cholesterol-lowering drugs are appropriate when changes in diet and physical activity don’t cut it.

Such drugs, including statins, are used in adults to reduce the risk of heart disease, a major killer in Western countries. But it isn’t clear if they also work for kids.

The new study, published in the journal Pediatrics, shows that after a few years, some youngsters with high cholesterol would no longer be considered for drug treatment according to guidelines.

While this isn’t an argument to abandon drug therapy altogether, doctors shouldn’t jump the gun when treating kids for cholesterol, the researchers caution.

“Both in kids and in adults there is quite a bit of variability over time,” David S. Freedman of the CDC told Reuters Health. “People with very, very high cholesterol are likely to be those that are having a bad cholesterol day.”

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Joseph P. Arpaia, MD

July 19, 2010 at 3:52 pm

Since cholesterol is used as a building block for cellular components shouldn’t we be concerned that perhaps growing kids need more cholesterol because they are, well, growing. So maybe lowering their cholesterol would be a bad idea.

Stephen Guy-Clarke

July 20, 2010 at 3:05 am

Cardiologist Peter Langsjoen notes that statin treatment may lead to heart muscle weakening and failure. ‘It occurs because statin drugs block the production of coenzyme Q10, vital for the production of cell energy,’ says Langsjoen. ‘Evidence to the FDA shows marked reduction of CoQ10 in patients on statin drugs.’
So with children as young as 10 being offered statins another point to be borne in mind is the use of long term drug therapy to lower cholesterol levels, where it is unclear what the full effects might be over a 30 year period. In spite of this, the Food and Drug Administration (FDA) gives approval for this class of drugs on the basis of less than 10 years’ clinical trials.