title: Pediatric dyslipidemia: recommendations for clinical management.
abstract: During the last 50 years, it has become evident that atherosclerosis originates in childhood. Although cardiovascular disease (CVD) events are rare in children, autopsy data and imaging studies have documented subclinical disease in association with measurable risk factors during childhood. When present at a young age, risk factors track into adulthood and have been associated with a moderate to high risk of future CVD. As such, the ability to identify this vulnerable population creates the opportunity to prevent the development of risk factors and future CVD events with effective management of genetic and acquired risk factors. In 2011, the National Heart, Lung, and Blood Institute Expert Panel published comprehensive guidelines summarizing the current evidence and providing developmentally appropriate recommendations for screening, treatment, and follow-up of children and adults younger than 21 years at risk for premature CVDs such as myocardial infarction and stroke. In addition to screening individuals with a family history of hypercholesterolemia and/or premature CVD, the Expert Panel recommended universal screening of all children between 9 and 11 years of age and then again between 17 and 21 years of age. Although the recommendation for universal screening, regardless of general health or the presence/absence of risk factors of CVD, is not without controversy, this review serves to create awareness among healthcare providers, elected officials, and the lay public about the burden of CVD, the opportunity for prevention, and the benefits of early and effective therapeutic intervention with lifestyle changes and lipid-lowering medications.
authors.affiliation: From the Department of Pediatric Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, Texas, the Division of Cardiology, Scott and White Healthcare, Texas A&M University, Temple, Texas, and the Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma.
authors.forename: Don P
authors.initials: DP
authors.lastname: Wilson
authors.affiliation: From the Department of Pediatric Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, Texas, the Division of Cardiology, Scott and White Healthcare, Texas A&M University, Temple, Texas, and the Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma.
authors.forename: Catherine
authors.initials: C
authors.lastname: McNeal
authors.affiliation: From the Department of Pediatric Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, Texas, the Division of Cardiology, Scott and White Healthcare, Texas A&M University, Temple, Texas, and the Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma.
authors.forename: Piers
authors.initials: P
authors.lastname: Blackett
mesh_terms: D000293:Adolescent; D050197:Atherosclerosis / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D050171:Dyslipidemias / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D058607:Fibric Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008403:Mass Screening / Q000592:standards; D017410:Practice Guidelines as Topic; D018570:Risk Assessment / Q000592:standards; D040242:Risk Reduction Behavior; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015525:Fatty Acids, Omega-3; D058607:Fibric Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D014280:Triglycerides