Giving Statins to Kids Divides Medical Experts
Cholesterol-lowering drugs hold risks along with possible benefits
(HealthDay News) -- As Americans get fatter, more are told by doctors that their cholesterol levels are too high -- along with their weight -- and that they should take a statin. The drugs lower cholesterol and fats in the blood by inhibiting an enzyme that helps make cholesterol.
But what if the patient is a child?
According to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases, 66 percent of adults in the United States are overweight or obese, and growing numbers of children are, too -- 10 percent of preschoolers and roughly 20 percent of school-age kids, government data show.
The U.S. Department of Health and Human Services says that being overweight as a child increases the risk for obesity in adolescence and young adulthood. In other words, many kids don't "grow out of" being overweight.
But while statins help adults, whether children should take them to fight the effects on their hearts has divided the medical community.
The American Academy of Pediatrics and the American Heart Association have recommended that obese children as young as 8 years old be treated with statins if other changes don't improve their health.
"For children with very high levels of LDL cholesterol at age 8 or older, physicians should consider statins if lifestyle and diet intervention have not been successful," Dr. Stephen R. Daniels, chairman of pediatrics at the University of Colorado Denver School of Medicine and Children's Hospital in Denver, told HealthDay.
Age 8 is the youngest age for which statin treatment has been approved by the U.S. Food and Drug Administration, Daniels said. It's also the age when the arteries begin to suffer from aggressive buildup of plaque, a process called atherosclerosis.
"Most of the data we have now have shown statins are very effective in lowering cholesterol, and as effective and safe in adolescents as they are in adults," Daniels said. "The most recent studies have shown statins can not only lower cholesterol but can improve certain measures of vascular structure and function associated with atherosclerosis in adults."
The side effects caused by statins -- elevation of liver enzymes, problems with muscle inflammation -- "can be monitored with lab tests," Daniels said.
But others think that treating children with cholesterol-lowering drugs is too expensive, given the potential for long-term use, and too risky, given that the effect of taking the drugs for decades remains unknown.
"What I'm afraid of is that someone will have a modest elevation in cholesterol at age 8 without a bad family history, and an overzealous doctor will say, 'You need to be on a statin,'" Dr. Simeon Margolis, professor of medicine and biological chemistry at Johns Hopkins University, told HealthDay. "That means this child will be taking a statin for 60 years or more."
Experts also fear that overuse of statin drugs could cause families to miss out on healthy habits that could benefit everyone.
"Rather than have the family as a whole initiate healthy lifestyle habits, they'll instead say, 'Well, we'll just take this pill,'" Margolis said.
On the Web
To learn more about raising safe and healthy kids, visit the U.S. Centers for Disease Control and Prevention.
SOURCES: HealthDay New; Simeon Margolis, M.D., Ph.D., professor, medicine and biological chemistry, Division of Endocrinology and Metabolism, Johns Hopkins University, Baltimore; Stephen R. Daniels, M.D., Ph.D., professor and chairman, Department of Pediatrics, University of Colorado Denver School of Medicine and Children's Hospital, Denver; Feb. 16, 2009, Circulation, online; U.S. National Cancer Institute (www.cancer.gov)
Author: Dennis Thompson
Publication Date: July 31, 2010
Copyright © 2010 ScoutNews, LLC. All rights reserved.