How to Know if Your Child Needs a Statin

The American Academy of Pediatrics caused a brouhaha last year when it said that kids as young as 8 should be put on statin drugs if diet and exercise don't work to lower high cholesterol levels. Many of its own members wondered whether it was wise to put children on drugs that they'd have to stay on for several decades in the absence of pediatric studies showing that this approach is safe and effective at preventing future heart attacks. A new study, which may calm those worries, shows that fewer than 1 percent of American children ages 12 to 17 actually need these drugs anyway.

Study author Earl Ford, a medical officer with the U.S. Public Health Service, tells WebMD, "It is a matter of opinion whether one thinks 0.8 percent is a small or large percentage." While I think most parents wouldn't worry too much if you tell them that 99.2 percent of kids aren't on statins, they would raise their eyebrows if told the actual number of kids who should be on them. With 25 million adolescents in the United States, 200,000 teens qualify for statins under the AAP guidelines—not an inconsequential number if it later turns out that statins pose long-term hazards for kids or don't actually make a difference in preventing heart attacks in adulthood when started at age 12.

That being said, statins are considered to be very safe in adults and have been shown to be lifesaving, particularly for those who have already had heart attacks or artery-opening surgeries or who have diabetes. What's clear is that while some children may indeed benefit from statins, researchers should be following these kids to study their long-term health outcomes. It's simply not enough to say, "Well, only a small percentage of children need them anyway."

The AAP guidelines currently direct doctors to consider prescribing statins in children older than 8 whose levels of "bad," or LDL, cholesterol are more than 190 mg/dL or who have moderately elevated LDL (over 160 mg/dL) and have heart disease risk factors like insulin resistance, hypertension, or obesity. But a lot of doctors disagree with these guidelines, so here's what you need to know before deciding to give your child a statin.

For more: Is your child overweight? Here's the right approach to take.