A rational approach to treating hypercholesterolaemia in children. Weighing the risks and benefits

Drug Safety : an International Journal of Medical Toxicology and Drug Experience
S Tonstad

Abstract

Because atherosclerosis is a continuous process throughout life, expert panels have suggested guidelines to reduce the risk of cardiovascular disease, starting from childhood. The guidelines focus on population-based measures and on treating hypercholesterolaemia in individual children. Low-fat diets in children have been widely debated. There is little evidence that growth is stunted or that nutritional deficiencies arise if the energy that is lost by limiting fat intake is substituted with other nutrients. Dietary fibre, plant sterols and fish oils have been used to modify lipid levels in children; however, the efficacy of these dietary adjuncts is limited. Bile acid-binding resins are the only approved drugs to lower cholesterol levels in children and appear to be well tolerated. However, compliance with resins is low because of unpalatability, so low dosages are preferred and vitamin supplementation is prudent. Data on HMG CoA reductase inhibitors and fibrates are insufficient to recommend these drugs at present. Drug treatment should be restricted to children who are at exceptionally high risk of disease, usually those with genetic dyslipidaemias.

Citations

Feb 27, 2001·Progress in Pediatric Cardiology·T J. Starc
Dec 31, 2010·Vascular Health and Risk Management·Mohammad Hassan Nemati, Behrooz Astaneh
Aug 11, 2000·Paediatric Drugs·S Tonstad
Apr 24, 2012·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Paul S JellingerUNKNOWN AACE Task Force for Management of Dyslipidemia and Prevention of Atherosclerosis
Apr 25, 2017·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Paul S JellingerMichael Davidson

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