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Title: New Policy on Lipid Screening, Cardiovascular Health in Children From the AAP
URL: http://www.pslgroup.com/dg/22531A.htm
Doctor's Guide
July 7, 2008

NEW YORK -- July 7, 2008 -- The American Academy of Pediatrics (AAP) has issued new cholesterol screening and treatment recommendations for children. The policy statement, "Lipid Screening and Cardiovascular Health in Childhood," appears in the July 2008 issue of Pediatrics.

The new clinical report replaces the 1998 policy statement from the AAP entitled, "Cholesterol in Childhood." This report has taken on new urgency given the current epidemic of childhood obesity with the subsequent increasing risk of type 2 diabetes, hypertension, and cardiovascular disease (CVD) in older children and adults.

The policy statement recommends cholesterol screening of children and adolescents with a family history of high cholesterol or CVD, screening patients whose family history is unknown or those who have other factors for CVD including obesity, (body mass index [BMI] >=95th percentile), hypertension (blood pressure >=95th percentile), cigarette smoking, or diabetes.

The best method for testing is a fasting lipid profile, and screening should take place after age 2, but no later than age 10. If a child has values within the normal range, testing should be repeated in 3 to 5 years.

Pharmacologic intervention should be considered for children who are aged over 8 years and who have high low-density lipoprotein (LDL) concentrations (>=190 mg/dL or >=160 mg/dL with a family history of early heart disease or >=2 additional risk factors present or >=130 mg/dL if diabetes is present).

Younger patients who are overweight or obese and have a high triglyceride concentration or low high-density lipoprotein (HDL) concentration should focus on weight reduction as the primary treatment. This includes increased physical activity while receiving nutritional counselling, according to the Dietary Guidelines for Americans.

The statement also recommends the use of reduced-fat dairy products, such as 2% milk, for children aged as young as 1 year for whom overweight or obesity is a concern, or who have a family history of obesity, dyslipidaemia, or CVD.

For the complete revised policy statement, see:
http://pediatrics.aappublications.org/cgi/content/full/122/1/198


SOURCE: American Academy of Pediatrics

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