The AAP now recommends lipid screening in children (between ages 2 and 10) who have a family history of lipid abnormalities or of premature heart disease, or who have other risk factors for heart disease such as being overweight or obese, diabetes, or smokers.
For those with elevated LDL cholesterol levels or other cardiovascular risk factors, the AAP recommends lifestyle changes such as dietary changes and exercise. For overweight or obese children with elevated triglycerides and reduced HDL cholesterol levels (that is, for those who appear to have metabolic syndrome), weight loss and exercise are the primary recommendations.
In addition, the AAP now recommends drug therapy for lipid reduction in children 10 years of age or older who have not improved with diet and exercise, and who have lipid levels as follows:
- LDL cholesterol greater than 190 mg/dL in children without any other risk factors
- LDL greater than 160 mg/dL in children with obesity, hypertension, smoking, or positive family history of premature heart disease
- LDL greater than 130- mg/dL in children with diabetes
The authors of this new report assert that these relatively aggressive recommendations are supported by accumulating evidence of the morbidity produced by childhood obesity and its results, and by new evidence on the safety and efficacy of drug therapy for elevated lipid levels in young people.
Source:
Daniels SR, Greer FR, and the Committee on Nutrition. Lipid screening and cardiovascular health. Pediatrics 2008; 122:198-208.
