American Heart Association guidelines call for selective screening in children with a family history of high cholesterol and early heart disease. The first line of treatment for such children should be lifestyle changes, such as healthier eating and more physical activity, the guidelines say.
The AAP agrees with that approach, said Dr. Stephen R. Daniels, chairman of pediatrics at the University of Colorado at Denver, and a member of the committee that issued the guidelines.
"It's true for adults but especially true for children," Daniels said. "Clinicians should maximize their efforts on lifestyle factors before any consideration of medication."
The new report doesn't alter the AAP guidelines, Daniels said, but it might provide peace of mind for some parents.
"This shows that the number of adolescents eligible for medication is relatively small," he said. The AAP does not recommend routine cholesterol screening for all children, only those at higher risk or cardiovascular problems because of family history or other warning indicators, Daniels added.
An overall program for controlling cholesterol levels is described by the U.S. Heart, Lung, and Blood Institute.
SOURCES: Earl S. Ford, M.D., medical officer, U.S. Public Health Service, Atlanta; Stephen R. Daniels, M.D., chairman, pediatrics, University of Colorado, Denver; Feb. 16, 2009, Circulation, online
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