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Irish Journal of Medical Science (1971 -)

, Volume 188, Issue 1, pp 179–188 | Cite as

Cholesterol screening and statin use in children: a literature review

  • Karen KingEmail author
  • Alan Macken
  • Ophelia Blake
  • Clodagh S. O’Gorman
Review Article

Abstract

Atherosclerosis begins in childhood. Fatty streaks, the earliest precursor of atherosclerotic lesions, have been found in the coronary arteries of children of 2 years of age. Hypercholesterolaemia is a risk factor for coronary artery disease. Hypercholesterolaemia can be either primary, when it is characteristic of the main disease, or secondary when it occurs as a result of either a disease process or drug treatment. Given the risk of vascular disease, including myocardial infarction (MI), cerebrovascular accidents (CVA, also known as strokes), peripheral vascular disease (PVD) and ruptured aortic aneurysm, which may follow atherosclerosis, it is important to prevent or slow the early development of atherosclerotic lesions. This prevention necessitates the control of key risk factors such hypercholesterolaemia, dyslipidaemia, hypertension etc. However, at what point this prevention ought to occur, and in what form, is uncertain. Using pharmacological primary prevention for hypercholesterolaemia in the paediatric population is controversial. In an adult patient, hypercholesterolaemia warrants the initiation of a statin. Statins, also known as hydroxymethylglutaryl co-enzyme A inhibitors (or HMG-CoA inhibitors) act by altering cholesterol metabolism. In the paediatric population, the clinical course of vascular disease and the effect of altering this clinical course are less certain. This article reviews the published literature on hypercholesterolaemia in children and the use of statins as a treatment for dyslipidaemia in children. The US National Cholesterol Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents 2012 guidelines (NCEP guidelines) regarding the recognition and treatment of childhood dyslipidaemia are reviewed.

Keywords

Cholesterol Dyslipidaemia Hypercholesterolaemia Paediatrics Statins 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Royal Academy of Medicine in Ireland 2018

Authors and Affiliations

  1. 1.The Children’s Ark, Department of PaediatricsUniversity HospitalLimerickIreland
  2. 2.Graduate Entry Medical SchoolUniversity of LimerickLimerickIreland
  3. 3.National Children’s Research CentreDublin 12Ireland
  4. 4.Department of BiochemistryUniversity HospitalLimerickIreland

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