Pediatricians and cardiologist are still arguing over the American Academy of Pediatrics's recommendation last summer that children over age 2 should have a cholesterol test and that children as young as age 8 be given statins to control high cholesterol. The groups also disagree on whether all children should have an electrocardiogram before being given Ritalin to treat attention deficit hyperactivity disorder, with the cardiologists saying yes and the pediatricians saying no. I understand why reasonable doctors can agree on these cutting-edge treatment issues, but those disagreements don't make it easier for parents to decide what's best for their child.
Yesterday, my colleague Deborah Kotz reported on a new study that makes it a little bit easier to figure out. It looked at how many teenagers have high cholesterol and figured out that less than 1 percent of teens might need statins. That's still a lot of kids, particularly since the drugs' safety and effectiveness haven't been widely tested in children. Doctors just don't know what the long-term consequences of having high cholesterol in childhood might be, because until very recently only children with rare hereditary conditions have had high cholesterol. With the increase in child obesity, alas, that picture is changing.
Last month, the cardiologists said they weren't ready to start diagnosing children with metabolic syndrome, which is a precursor to heart disease in adults, because they just don't know enough about how it works in kids.