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Statins OK For Kids

Cholesterol-lowering drugs don't affect growth and development, study finds

MONDAY, Sept. 30, 2002 (HealthDayNews) -- Statins can lower high cholesterol levels in children as effectively as they do in adults, without affecting normal growth and development.

Statin treatment reduced every measure of heart-threatening blood cholesterol and lipid levels in children, says a report in tomorrow's issue of Circulation. After 48 weeks, total cholesterol dropped by 31 percent; LDL cholesterol, the "bad" kind that clots arteries, was down 41 percent, and triglycerides dropped by 9 percent.

The study included 173 young people aged 9 to 19 in seven countries on four continents, all with a genetic condition that gives them unusually high cholesterol levels. Some were given a placebo, while others got simvistatin, marketed as Zocor by Merck, with a starting dose of 10 milligrams a day that was gradually increased to 40 milligrams a day.

"No safety issues became evident," says the journal report. "…There was no evidence of any adverse effect from simvistatin on growth and pubertal development."

That last point is an important one, says Dr. Hugh D. Allen, a professor of pediatrics and internal medicine at Ohio State University and a spokesman for the American Heart Association.

"The question has been the possible impact of statin treatment on growth and puberty," Allen says. "This shows no impact on growth or puberty, and thus allows us to use these drugs in children. I have been looking for something like this."

The study will help reduce a slight sense of unease about statin therapy for young people, says Dr. Stephen R. Daniels, a professor of pediatrics at Cincinnati Children's Hospital Medical Center.

"This class of medications has been used in pediatrics for a number of years without a lot of data to back it up," he says. "This study indicates that they are as effective in children in adults, with a safety profile similar in pediatrics to that in adults. It also gives us some sense of the correct dosage to use in young patients."

Some questions remain, Allen says. "The next question is whether statin therapy will be as effective in young people who simply have elevated cholesterol, rather than familial hypercholesterolemia," he says. "That remains to be seen, but I am cautiously optimistic."

There has been concern about use of statins in young women who might become pregnant, because of a fear of possible birth defects, Daniels says. Previous studies were mostly conducted in boys, he notes. "This study was beneficial because it included girls and did not show an effect on growth and maturation," he says. "But the issue of pregnancy in adolescent females remains to be concerned about."

Treatment of high cholesterol, in adults or children, starts with dietary measures, but those are not often effective, Daniels says. The U.S. National Cholesterol Education Program recommends drug therapy when dietary changes are not effective for children aged 10 and older who have LDL cholesterol readings of 160 if they have other risk factors, such as an existing cardiovascular condition, and 190 if there are no other risk factors.

What To Do

You can get much more information about the dangers of high cholesterol in children and its treatment from the American Heart Association.

The National Library of Medicine has more on familial hypercholesterolemia.

SOURCES: Hugh D. Allen, M.D., professor, pediatrics and internal medicine, Ohio State University, Columbus; Stephen R. Daniels, M.D., professor, pediatrics, Cincinnati Children's Hospital Medical Center; Oct. 1, 2002, Circulation
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