Baltimore Health Examiner

Cholesterol: should we be testing our children?

New recommendations by the American Academy of Pediatrics (AAP) suggest that certain children should be checked for high cholesterol between the ages of 8 and 10, and then rechecked every three to five years, presumably for life.

For those with at least one parent with high cholesterol, a total cholesterol test is recommended.  For those with a family history of early heart disease (defined as a father or grandfather with heart disease before age 55 or a mother or grandmother with heart disease before age 65), a more extensive fasting lipid panel is recommended.  Other high-risk children include those with high blood pressure, diabetes or those who are overweight.

For children with significantly elevated LDL (“bad” cholesterol), the AAP suggests treatment with cholesterol drugs – possibly the same ones that dad is on.

I almost always agree with the AAP, but I was surprised by this recommendation.  While I certainly understand that they are trying to address the epidemic of food-related cardiovascular disease in this country, I think that the consequences of this new strategy simply cannot be known.

If children find out that they have high cholesterol in childhood but they don’t get treated for it, what will motivate them to start treatment as adults.  And when would they start it?  Sometimes things that you’ve had since childhood, that haven’t killed you yet, don’t seem like such a big deal.

Yet I worry more about the children who do get treated.  If children start cholesterol medicine at age 8, they may be on it for 70 years or so.   Is that really a good idea?  How can we know?  And will taking a cholesterol medicine throughout childhood have any unforeseen effects?  Again, we just can’t know.

I can see the benefit of waking up a family who has an overweight child with diabetes.  That child is at tremendously high risk of future heart disease and maybe a scary cholesterol result will compel them to turn down the sweets and turn up the veggies.  But the AAP recommendations include children who have one parent with high cholesterol or a parent/grandparent with early heart disease.  That net will catch a lot of kids.

My children fall into this high-risk group.  They are thin and athletic, but their father has high cholesterol and they lost a grandmother to heart disease in her forties.  I suppose I will have them tested, but what will I do if their cholesterol is high?  I really don’t know.  I just can’t see starting my 9 year old on a daily cholesterol pill.

I just can’t see it.

What would you do?

Dr. C.
www.insightmedicalconsultants.com

 

Topics: cardiology

Fish oil beats cholesterol drug in heart failure

Adding fish oil to standard therapy for patients with heart failure was more helpful than adding a potent cholesterol drug, according to a study published in The Lancet. The fish oil reduced hospital admissions and death, while the cholesterol... Read More
Topics: cardiology

Hospice: not just for cancer anymore

No one wants to hear, “it is time to call hospice.” No matter how serious a disease you are facing, it can be difficult to accept that cure is no longer an option.Yet delaying entrance into hospice is often a mistake. The transition... Read More
Topics: end of life

West Nile Virus: mosquitoes are more than an annoyance

Mosquitoes are more than annoying – they can be dangerous.Mosquitoes annoy me, but they don’t usually scare me.  However, when I was in Africa I felt differently.  In the early afternoon, when the mosquitoes were trolling for a... Read More

Top health tips for back-to-school children

Life is changing for many children and their parents – summer vacation is over and a new school year is about to begin.  Here are 8 tips for staying healthy during the school year.•    Don’t pick your nose. ... Read More
Topics: children's health

Do not ignore these symptoms!

Some symptoms should not be ignored. Most people know to go to the ER for chest pain and in a recent blog I discussed the symptoms of stroke. But there are some symptoms that people routinely ignore – sometimes with devastating consequences.Bleeding... Read More
Topics: cancer

Sleep Deprivation in Children - bratty or just tired?

Kids change when they don’t sleep enough.  Most parents have experienced this phenomenon first hand.My youngest daughter went to a sleepover party last night and, despite the mom’s Herculean efforts, she didn’t get to sleep until... Read More
Topics: children's health

Diarrhea without a diagnosis -- what could it be?

 I have had several patients recently with chronic diarrhea. In each of the cases, the people had been living with their symptoms for many months or even years without a definitive diagnosis. Everyone, both patient and doctor, seemed to have become... Read More
Topics: gastroenterology

Gymnastics vs. family dinners: where should we draw the line?

Gymnastics is hot right now. Many people are excited to watch our Olympians and many little girls dream of being Shawn Johnson. My seven year old daughter is one of them.She does handstands and cartwheels with abandon and anxiously looks forward to... Read More
Topics: children's health

Screening for Prostate Cancer - making sense of muddy waters

Who would think that the prostate would be so controversial? PSA screening for men age 75 and above has gotten the thumbs down from the U.S. Preventive Services Task Force. They assessed that the risks of screening this population are greater than the... Read More
Topics: men's health