Summary of the American Heart Association’s Scientific Statement on Drug Therapy of High-Risk Lipid Abnormalities in Children and Adolescents

Abstract

Drug therapy of lipid abnormalities in children and adolescents has been surrounded with controversy. Much of the debate is about the evidence that intervening in asymptomatic youth will reduce disease morbidity or mortality in adulthood. There is also particular concern that the increasing prevalence of lipid abnormalities associated with the epidemic of pediatric obesity will lead to a generation of children taking long-term medication for lifestyle-related issues. The Writing Group, therefore, sought to examine the current state of evidence and guidelines and to provide clarifications and modifications, which are detailed in their Scientific Statement.1 See Circulation . 2007;115:1948–1967 A substantial body of evidence now exists to assert that the atherosclerotic process begins in childhood and is associated with the recognized cardiovascular risk factors. Pathologic studies, such as the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Study, have shown strong associations with the extent of early atherosclerotic lesions and levels of risk factors, including lipid abnormalities. An important observation from pathology studies has been the geometric association between increasing number of risk factors and the extent of lesions, which has important implications in view of the increasing prevalence of risk factor clustering associated with …