If cholesterol-lowering drugs called statins be given to children apparently depends on you ask.
Major associations of health in the United States have recommended that obese children as young as 8 years treated with statins if diet and lifestyle changes fail to improve their health.
However, the guidelines issued by the American Academy of Pediatrics and the American Heart Association, have raised the debate in the medical community.
Some believe that treatment with statins as essential in the fight against public health as a symptom of the obesity epidemic. Others believe that treatment of children with cholesterol-lowering drugs is a costly, with potential long-term consequences are not fully understood.
“What I fear is that someone will have a modest elevation in cholesterol levels in the age of 8 years without a bad family history, and an overzealous doctor say, ’You have to be on a statin,” said Dr. Simeon Margolis, professor of medicine and biological chemistry at Johns Hopkins University. “That means that this child is going to take a statin for 60 years or more.”
Obesity in adolescents has become a major health concern in the United States, with medical experts predicting potentially overwhelming levels of diabetes and heart disease as overweight children mature into adults.
Statins work by inhibiting the body’s production of cholesterol while promoting the ability to remove “bad” (LDL) from the bloodstream.
“The consensus is that, for children with very high levels of LDL cholesterol at the age of 8 years of age or older, physicians should consider statin therapy if lifestyle and dietary intervention have been unsuccessful” , said Dr. Stephen R. Daniels, chief of pediatrics at the University of Colorado Denver School of Medicine and Children’s Hospital in Denver.
He said that 8 is the minor child for treatment with statins, has been approved by the U.S. Food and Drug Administration. It is also the time when the arteries begin to suffer from aggressive buildup of plaque, a process called atherosclerosis.
“In that pre-pubescent to pubescent early stage, the process becomes more aggressive,” said Daniels. “At the end of adolescence or a little over 20 years, there can be advanced plaques, which are of concern. The idea is that we could intervene early, their last experience with heart attacks later in life will be more favorable.”
Research has found that statin therapy can have very positive long-term health benefits for some children.
“Most of the data we have now shown statins are very effective in reducing cholesterol and how effective and safe in adolescents and adults,” said Daniels. “The most recent studies have revealed not only the statins can lower cholesterol, but may improve some measures of vascular structure and function associated with atherosclerosis in adults.”
Side effects caused by statins – elevated liver enzymes, the problems associated with inflammation of the muscle – can be monitored with laboratory tests, “said Daniels.
However, if doctors stuck rigidly to the recommendations of health organizations, it seems that not many children would be given statins.
Less than 1 percent of adolescents aged 12 to 17 years for America to fulfill the American Academy of Pediatrics guidelines for statin therapy, according to a medical examination of the data published this year in the journal circulation by Dr. Earl S. Ford, a medical officer with the U.S. Public Health Service in Atlanta. That’s about 200,000 children.
Margolis, is concerned that many more children will be treated with statins by doctors that are not strictly following the guidelines. If that happens, families are potentially pay large sums of drug money and the monitoring of health screenings that are not necessary, he said.
Beyond that, there is also the cost to its own image. “The child who is not a healthy 8 years, but is sick,” said Margolis.
Excessive use of statin drugs also may cause families to lose the opportunity to improve the health of each member. “Instead of having the entire family begin habits healthy lifestyle, rather than what he says, ’Well, let’s take this pill,” said Margolis.
Some doctors are also concerned about the effects that decades of treatment with statins may have in the long term health of someone who starts taking in adolescence.
“Nobody has had over 60 years, so we do not know what will happen,” said Margolis. However, he added that he is not so worried about the long-term health risks because it is the other costs to society.
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