Parents should think twice before starting children on statin drugs to lower cholesterol, according to a new report on children and statins from Consumer Reports Best Buy Drugs. That's because the powerful drugs have not been extensively tested in children, and they can have serious side effects, especially muscle pain. Instead, parents should consider the two best ways to lower cholesterol without drugs: more exercise, and a healthy diet.
With about 20 percent of children now considered obese and at risk of high cholesterol, many more parents will be facing the question of whether they should put children on statins, an idea that would have seemed odd just a few years ago. In 2008, the American Academy of Pediatrics said that statins could be used for children ages 8 and above, and that 2-year-olds should be given cholesterol tests if they appear to be at risk of obesity. In 2009, doctors wrote children 2.3 million prescriptions for statins. But John Santa, an internist who directs Consumer Reports Health Ratings Center, says parents should ask themselves two questions if their child has been diagnosed with high cholesterol before turning to statins:
- Does your child have traditional risk factors for cardiovascular disease? These include being overweight or obese; having diabetes; having a family history of premature heart disease; or being a smoker. If so, talk with your pediatrician about how to lower your child's cholesterol without drugs.
- Does your child have high cholesterol but no risk factors for heart disease? If so, there's no evidence that treating child's high cholesterol with drugs will lower the risk of heart attacks once that child becomes an adult.
"With children, you're talking about many decades of potential exposure to the drugs," Santa says. He points out that children metabolize drugs very differently than parents, so it's impossible to presume that the drugs' safety and effectiveness would be the same for them. Indeed, statins haven't been tested in children long term for safety or effectiveness, and taking statins is usually considered a lifetime affair. With a new statin drug, Livalo, about to be introduced, expect a barrage of advertisements directed at doctors and parents. "Let's curb our enthusiasm here and be a little careful," Santa says.
If your child has high LDL cholesterol, generally considered 130 mg/dL or greater, talk with your pediatrician about options, and don't go in demanding drugs, Santa suggests. "Ask about the risks and benefits. A careful parent who reads both sides, I think, will have good questions for their physician."