NIH Guidelines for Lipid Management in Children and Adolescents

Bile acid sequestrants may be used in conjunction with a statin if the patient is not at the LDL-C goal. Side effects of these medications are usually limited to gastrointestinal symptoms. In addition, fish oil appears to be safe in the case of elevated triglycerides, although no randomized, controlled trial has been performed for its use in children. Fibric acid derivatives, cholesterol absorption inhibitors, and niacin are rarely used in children. They should be used only in consultation with a lipid specialist.

The Bottom Line

Atherosclerosis begins in childhood and is strongly influenced by lipid levels. The NIH guidelines recommend universal screening for all children, regardless of risk factors, between the ages of 9 and 11 years, and at least once between the ages of 17 and 21 years. Prompt initiation of lifestyle and diet management, with or without medical therapy, may delay or prevent the onset of CVD.

Reference

• National Institutes of Health. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Full Report, 2011.

Dr. Schroeder is a resident in the family medicine residency program at Abington (Pa.) Memorial Hospital. Dr. Skolnik is an associate director of the family medicine residency program at Abington Memorial Hospital.