Statins in children: yes or no?
The main triggering factor of atherosclerosis or accumulation of fat in the walls of the heart arteries and other arteries is bad cholesterol or Low Density Lipoprotein (LDL).
While clinical events such as myocardial infarction and ischemic stroke usually occur in adulthood, the disease begins in childhood and is aggravated by other factors such as obesity , which is common in many children.
Parents and pediatricians must work together to prevent these events. When a child reaches the age of 9 to 12, we should request a complete blood test that includes a lipid profile (blood fats) and investigate the family history , because high cholesterol is inherited.
This article is based on a question I received from a father who has been taking statins since he was 35 about his 14-year-old son , who is overweight and has been prescribed the drug.
The use of statins in children has been controversial, and the father was reluctant to give them to his son because he had seen "very knowledgeable people" say on social media that these drugs kill children.
According to the American Academy of Pediatrics and expert cardiologists, statins should be considered starting at age 8 to 10 in selected cases.
- Bad cholesterol (LDL) at 190 mg/dl or higher with no other added factor
- LDL at 160 mg/dl with:
- Obesity
- High blood pressure
- Metabolic syndrome
- Passive smoking
- Family history of high cholesterol or early cardiovascular disease
- LDL greater than 130 mg/dl in diabetic children.
And its use can be considered when there has been no improvement after making a lifestyle change: physical activity , sport, healthy eating and good quality sleep, without metabolic improvement evidenced in the laboratory 3 to 6 months after taking these measures.
Statins are generally well tolerated in adults and children and are an urgent measure for long-term prevention and protection when there is a genetic predisposition, additional aggravating factors, and when conservative measures have failed.
Some side effects of statins that should be watched for include:
- Muscle weakness and pain
- Elevated liver enzymes
- Some hormonal impact (rare)
- Nausea and abdominal pain.
It is our duty to educate parents so they understand that using or not using medication based on "advice" on social media is not right. Seeking responsible professional guidance can help them, just as it helped the father and son in this story.
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