Children May Have Cholesterol Problems, Too

High cholesterol levels
are not just found in adults. Children may have high cholesterol, too, even
without being overweight. Over years, cholesterol overload has similar
hazards as in adults -- clogged arteries and injury to the heart.



The Children's Hospital of Philadelphia recommends that children,
starting at age two years, should have a complete cholesterol profile
checked after an overnight fasting if they have a family history of high
cholesterol or of early heart disease, in line with similar recommendations
from the American Academy of Pediatrics and the American Heart Association.
Those who do not have a family history but have other risk factors for
early heart disease, such as being overweight, high blood pressure,
diabetes, smoking, poor diet, and sedentary lifestyle should also be
screened.



"Although the most common reasons for high cholesterol are poor diet,
being overweight, and not getting enough exercise, some apparently healthy
children inherit high cholesterol levels from their parents," said Julie
Brothers, M.D., medical director of the Lipid Heart Clinic at The
Children's Hospital of Philadelphia. "Overall, we've noticed an increase in
children's cholesterol levels the past several years and this is a
disturbing trend."



Children with a family history of high cholesterol or early heart
disease, even if they have normal weight, should be routinely screened, as
they may have a genetic predisposition for excess cholesterol levels --
familial hypercholesterolemia (FH). These children have high levels of
low-density lipoprotein (LDL), also called "bad cholesterol," beginning at
birth, which can lead to early thickening of the artery walls, premature
cardiovascular disease and an increased risk of early heart attack.



Familial hypercholesterolemia is underestimated in the community and in
pediatric primary care practices. Children with FH have no symptoms or
signs of their condition and often do not fit the profile of someone who is
at risk; they usually have a normal weight and a healthy lifestyle and
diet. However, in addition to a family history of high cholesterol, they
usually have a family history of early heart disease. Children with a
parent, grandparent, sibling, aunt, or uncle with high cholesterol or who
has suffered a cardiac event before the age of 55 should be routinely
monitored.



Children who are overweight or obese should also have their cholesterol
levels routinely screened by pediatric healthcare professionals, as this
also places them at increased risk of developing early heart disease.



It is important to differentiate between obese children with high
cholesterol and those with FH, which is not traditionally associated with
obesity; however, with the obesity epidemic, many children with FH now also
are overweight or obese.



"Cholesterol levels in children who are obese usually respond well to
diet and lifestyle modifications, whereas children with FH often need
medications in addition to diet and exercise," added Dr. Brothers.



Modifications to diet and increased physical activity are the
first-line treatments for children identified with raised cholesterol
levels. Another option is putting a child on statin therapy, which is a
lifetime commitment.



The Lipid Heart Clinic at The Children's Hospital of Philadelphia
evaluates and treats children and adolescents who have high levels of
lipids (fats) in their blood. Elevated lipids put young people at risk for
heart disease later in life.



The Children's Hospital of Philadelphia was founded in 1855 as the
nation's first pediatric hospital. Through its long-standing commitment to
providing exceptional patient care, training new generations of pediatric
healthcare professionals and pioneering major research initiatives,
Children's Hospital has fostered many discoveries that have benefited
children worldwide. Its pediatric research program is among the largest in
the country, ranking third in National Institutes of Health funding. In
addition, its unique family-centered care and public service programs have
brought the 430-bed hospital recognition as a leading advocate for children
and adolescents. For more information, visit chop.


The Children's Hospital of Philadelphia

chop