"There is overwhelming evidence now that
atherosclerosis, or a build up of plaque in the
arteries, starts in childhood, not when you're
50 or 60," says David J. Driscoll, MD, professor
of pediatrics and director of the Division of
Pediatric Cardiology at the Mayo Clinic in
Rochester, MN. We know this from autopsies
performed on children who die of accidental
deaths, he notes. Other studies on young
soldiers who died in Korea and Vietnam showed
that by their early 20s, many already had the
beginnings of atherosclerosis. "Some of them
with pretty significantly advanced disease."
We also know that there's a correlation between
cholesterol and other blood fat levels in
children and the degree of fatty streaking or
atherosclerosis in their arteries, he said. In
fact, children and adolescents with high
cholesterol levels are more likely than the
general population to have high levels as
adults.
When to Worry
Cholesterol levels in children age two 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 nine 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."
KidsHealth.org
- KidsHealth is the largest and most visited site
on the Web providing doctor-approved health
information about children from before birth
through adolescence. Created by The Nemours
Foundation's Center for Children's Health Media,
KidsHealth provides families with accurate,
up-to-date, and jargon-free health information
they can use.
www.kidshealth.org
Sources used to develop this article:
