When to Worry
Cholesterol levels in children age 2 to 19 years should be less than 170 and LDL levels should be less than 110. Total cholesterol levels greater than 200 and/or LDL levels greater than 130 are considered high. Blood pressure levels in children vary by age, height, and weight, so talk to your doctor about where your child's should be.
"What we don't yet know is if lowering a child's cholesterol levels changes their risk later in life for developing coronary disease," says Dr. Driscoll. "Intuitively, you would think that it would, but those studies haven't been done yet." And a substantial number of children with high cholesterol levels do become adults with desirable cholesterol levels without intervention.
Nonetheless, the U.S. National Cholesterol Education Program recommends cholesterol-lowering drugs for children over age 10 whose LDL (that's the "bad" cholesterol) remains high even after they've changed their diet. Until fairly recently, the most common class of such drugs, statins, were not approved for use in children, and few large studies on their effects in children had been conducted.
But a study published in an October 2002 issue of the journal Circulation found the cholesterol-lowering drug simvastatin (Zocor) significantly reduced cholesterol levels in children with an inherited form of high cholesterol. The study, on 173 children between ages 9 and 18, also found that even after 48 weeks on the drug, there was no effect on growth or development of puberty.
Today, statins are generally considered safe to use in children and adolescents, says Dr. Driscoll, "although we use them a bit more cautiously than with adults because if you take a 55-year-old person and put them on a drug for the rest of their life and they live to be 85, that's 30 years; but with a 15-year-old, you may be talking about a very long time on that drug."
Sources: American Academy of Pediatrics Committee on Nutrition, Cholesterol in childhood. January 1998. American Heart Association, High Blood Pressure in Children recommendation American Heart Association, Cholesterol and Atherosclerosis in Children scientific position Circulation, Efficacy and safety of statin therapy in children with familial hypercholesterolemia, October 2002.
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