The American Academy of Pediatrics sparked a firestorm on Monday with recommendations that cholesterol lowering drugs could be given to children over eight years old.
It also suggested screening high risk children after age two (press release).
The new guidelines, published in the journal Pediatrics, replaces previous advice from 1998 and states “This report has taken on new urgency given the current epidemic of childhood obesity with the subsequent increasing risk of type 2 diabetes mellitus, hypertension, and cardiovascular disease in older children and adults.”
It was, said the Minneapolis Star Tribune, “a shocking and regrettable milestone”. The NY Times warned it was “certain to create controversy amid a continuing debate about the use of prescription drugs in children”.
And so it came to pass…
One of the major problems with the issue is that there aren’t many studies on using such drugs, of which statins are the mainstay, in young children.
“We don’t know the risks and the benefits,” says Beatrice Golomb, cholesterol researcher and doctor at the University of California San Diego (LA Times). “We don’t really know the impact of long-term use.”
“What are the data that show this is helpful preventing heart attacks?” says Darshak Sanghavi, doctor and professor at the University of Massachusetts (NY Times follow up article). “How many heart attacks do we hope to prevent this way? There’s no data regarding that.”
The LA Times also highlights that the guidelines failed to disclose authors’ links to drug companies.
Not everyone is negative about the guidelines though, especially as regards screening.
“It is long past due,” said Wesley Covitz, professor of cardiology at Wake Forest University Health Sciences in Winston Salem, told ABC. “There has been a complacency among pediatric providers relevant to screening for high cholesterol.”
Also on ABC, Gerald Fletcher, a cardiologist and professor of medicine at the Mayo Clinic in Jacksonville, says, “I’m glad to see the pediatricians give the go-ahead to screen kids earlier and prevent these horrible problems. It’s nothing but a finger prick to do the screen.”