We were appalled when we first heard that the American Academy of Pediatrics has recommended that some children as young as 8 be given drugs to reduce their cholesterol levels — and that they could end up taking these drugs for the rest of their lives. After reading the academy’s report, we are now more dismayed about what this recommendation says about children’s health.
The academy recommended that children as young as 2 who have risk factors for heart disease or whose family medical history is not known should be screened for high cholesterol. And it proposed that children 8 or older with very high concentrations of LDL, or “bad,” cholesterol — 190 milligrams per deciliter or above — be considered for drug treatment to drive levels below 160 or even much lower.
The new recommendations are based on evidence that the damage leading to heart disease begins early in life. While cholesterol levels among adolescents have remained stable, the new stance reflects concerns that childhood obesity is increasing and that the prevalence of high blood pressure may be increasing.
The recommendation has provoked furious debate among pediatricians, as Tara Parker-Pope reported in Science Times on Tuesday. Critics complain that there is no evidence that giving statins to children will prevent heart attacks later in life and that there is no data on the potential side effects of taking the drugs for decades.
Still, it can’t be good for children to have very high cholesterol levels. The new recommendations apply to these high-risk youngsters, not to all children. Short-term studies indicate that the statins are safe and effective in children and adolescents, and one statin has been approved by the Food and Drug Administration for use in children as young as 8.
The academy did urge that good diets and physical exercise be tried first, but the drug recommendation has attracted the most attention. We do fear that it will open the way for drug companies to bombard anxious parents with ads promoting these and other products and increase the number of parents insisting on prescriptions for their children.
The ease of popping pills should not distract parents, health professionals or policy makers from the more arduous tasks of cutting back on junk foods, promoting healthy diets and putting physical education back into the schools.
