Drug therapy of high-risk lipid abnormalities in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee, Council of Cardiovascular Disease in the Young, with the Council on Cardiovascular Nursing.
Despite compliance with lifestyle recommendations, some children and adolescents with high-risk hyperlipidemia will require lipid-lowering drug therapy, particularly those with familial hypercholesterolemia. The purpose of this statement is to examine new evidence on the association of lipid abnormalities with early atherosclerosis, discuss challenges with previous guidelines, and highlight results of clinical trials with statin therapy in children and adolescents with familial hypercholesterolemia or severe hypercholesterolemia. Recommendations are provided to guide decision-making with regard to patient selection, initiation, monitoring, and maintenance of drug therapy.
McCrindle
Brian W
BW
Hospital for Sick Children, Toronto, Canada.
Urbina
Elaine M
EM
Dennison
Barbara A
BA
Jacobson
Marc S
MS
Steinberger
Julia
J
Rocchini
Albert P
AP
Hayman
Laura L
LL
Daniels
Stephen R
SR
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000924:Anticholesteremic Agents / Q000145:classification / Q000627:therapeutic use; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D002791:Cholesterol, Dietary; D008078:Cholesterol, LDL / Q000097:blood; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D000075202:Contraindications; D048909:Diabetes Complications / Q000453:epidemiology; D018752:Diet, Fat-Restricted; D004041:Dietary Fats; D018450:Disease Progression; D050171:Dyslipidemias / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy / Q000188:drug therapy*; D005081:Exercise Therapy; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000009:adverse effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006938:Hyperlipoproteinemia Type II / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy / Q000188:drug therapy / Q000453:epidemiology; D006951:Hyperlipoproteinemias / Q000145:classification / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D008517:Phytotherapy; D012307:Risk Factors; D014463:Ultrasonography
D000924:Anticholesteremic Agents; D002791:Cholesterol, Dietary; D008078:Cholesterol, LDL; D004041:Dietary Fats; D017320:HIV Protease Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents