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Published on: September 15, 2018
Management of hypercholesterolemia in children
Marjet J A M Braamskamp1, Barbara A Hutten, Albert Wiegman
1Academic Medical Center, Department of Vascular Medicine, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands, j.a.braamskamp@amc.uva.nl.
Insights
Early identification and treatment of childhood hypercholesterolemia are crucial for preventing adult cardiovascular disease (CVD). Lifestyle changes and medications like statins are effective, but long-term safety data for early intervention is needed.
Area of Science:
- Pediatrics
- Cardiology
- Public Health
Background:
- Cardiovascular disease (CVD) is a leading cause of death.
- Hypercholesterolemia in children, whether hereditary or secondary, is a significant risk factor for future CVD.
- Early detection and management of childhood hypercholesterolemia are vital for long-term cardiovascular health.
Purpose of the Study:
- To review current screening strategies for identifying children with hypercholesterolemia.
- To discuss treatment options for pediatric hypercholesterolemia.
- To highlight the need for long-term follow-up studies on early-onset treatment.
Main Methods:
- Review of existing literature on pediatric hypercholesterolemia screening and treatment.
- Analysis of current therapeutic approaches, including lifestyle modifications and pharmacotherapies.
- Identification of research gaps concerning the long-term effects of early treatment initiation.
Main Results:
- Screening strategies include universal screening and case finding.
- Lifestyle adjustment is the primary treatment, followed by pharmacotherapy if needed.
- Statins, ezetimibe, and bile acid sequestrants are effective in lowering LDL cholesterol.
Conclusions:
- Current treatments for pediatric hypercholesterolemia are safe and effective in lowering LDL cholesterol.
- Long-term studies are required to confirm the safety and efficacy of initiating treatment at a young age for CVD prevention.
Abstract:
Cardiovascular disease (CVD) remains the leading cause of death and morbidity in our society. One of the major risk factors for CVD is hypercholesterolemia. Hypercholesterolemia in children can be caused by a hereditary disorder or can be secondary to other diseases or drugs. In order to prevent CVD later in life, children with hypercholesterolemia should be identified and treated as early as possible. Currently, several different screening strategies have been developed, using either universal screening or case finding to search for children at risk. Once those children are identified, the first step in treatment is lifestyle adjustment. If cholesterol levels remain elevated, the drugs of first choice are statins. Other pharmacological options are ezetimibe or bile acid sequestrants. These agents have all proven to be safe and effective in lowering low-density lipoprotein cholesterol levels and improving surrogate markers of CVD. However, there is a need for long-term follow-up studies to answer the question as to whether it is safe to initiate treatment at a young age to prevent CVD later in life.
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