Protecting Kids From Heart Disease

yeah

good article wrote paper on it in class..wooo hoo

great article

Be patient to our kids

I am so sad to know that cardiac risk factors are so popular in our kids. I am wondering if the life span will be shorter in our kids than that in our peers.

What amazed me is why doctors prescribe the cholesterol-lowering medications to children even they don't know if these medication are actually benefecial. One of reason is that they may think diet and exercise has weak effect on them, the other reason, in my opinion, is that we are not patient to our kids. That is true for both parents and doctors. For example, it is commonly seen that many children are eating junk foods in everywhere. Chips, coke, popcorns,cookies actually are their favariates, which even be provided in daycare's snack. The situation is getting worse when children sit for a long time everyday because they are attractive in Vidoes, TV sets and internet games. For majority of parents, they are used to speak "please stop it" for at most two times and then give up if children are still on these unhealthy things. So, we just need more patience to our kids. We should spend more time on some interpersonal activities, such as playing games, telling stories, and doing exercises. I don't want my kid developing cardiovascular disease when i am in middle ages even i am healthy enough to take care of them.

I also hope more patience doctors will have when they treat our little kids. Please carefully prescribe drugs with unclear side effects to children. Just try to tell their parents continously taking action on diet and exercise once again before you write down the "dangerous" recipes.

high cholesterol in kids

"Drugs are clearly necessary for kids with . . . an inherited form of high cholesterol in which LDL levels soar well above 200 mg/dL."

Actually, the situation is much more complicated than this statement implies. My teenage daughter has this disease, which is called heterozygous familial hypercholesterolemia (heFH). While kids with heFH have more atherosclerosis than normal kids, and treating them with a statin slows or prevents the growth of atherosclerosis, there are no studies that show that starting treatment in childhood prevents more heart attacks than starting at, say, age 20. We simply don't know. It is quite possible that the increased atherosclerosis is reversible by treating these kids starting in early adulthood.

In any case, the pros and cons should be discussed with the child and his/her parents. In the vast majority of cases, there seems no compelling reason to start treatment at age 8, as recommended in the American Academy of Pediatrics guidelines, or age 10 (in boys) or after menses (in girls), as recommended in the American Heart Association guidelines. Rather, waiting until the child is a teenager seems reasonable. The following factors seem relevant in determining whether statins should be initiated in childhood:

1. How high is the child's LDL?

2. Does the child have other risk factors?

3. Is there a family history of extremely early heart disease, such as heart attacks in men below age 50 or women below age 60? If so, how closely related are these relatives to the patient?

4. There should be a higher threshold for initiating treatment with statins in girls, as statins are contraindicated in pregnancy.

If drug treatment is initiated, the only drugs shown to be effective are statins. Ezetimibe and bile acid sequestrants should be avoided.

Marilyn Mann