Few U.S. teens need cholesterol-lowering drugs

Fewer than 1 percent of adolescents in the U.S. are candidates for cholesterol-lowering drugs, based on updated guidelines released last year by the American Academy of Pediatrics.

The guidelines indicate that statin type drugs, such as Lipitor and Zocor, may be considered for any child with LDL "bad" cholesterol levels above 190 milligrams per decaliter (mg/dL).

If other risk factors, such as obesity and high blood pressure, are present, treatment should begin at 160 mg/dL; if diabetes is present, treatment at 130 mg/dL or higher may be appropriate.

"I think the new recommendations caused a lot of people to be concerned about children having high cholesterol and being put on medications for a good part of their lives," lead author Dr. Earl S. Ford, from the Centers for Disease Control and Prevention, Atlanta, said in a statement. "In this study, we set out to produce numbers so we would know exactly what we are talking about in terms of the percentages of US children who may need to be treated or may have high cholesterol levels."

As reported in the journal Circulation, the research team assessed the cholesterol status of U.S. children and adolescents by analyzing data from the National Health and Nutrition Examination Survey from 1999 to 2006.

The average total cholesterol level for individuals 6 to 17 years of age was 163 mg/dL. Among those 12 to 17 years of age, the average LDL cholesterol level was 90.2 mg/dL.

Girls had total cholesterol levels that were 3.6 mg/dL higher, on average, than those seen in boys. Compared with whites, African Americans had levels that were 2.6 mg/dL higher, while Mexican Americans had levels that were 1.9 mg/dL lower.

Depending on the criteria that were used, between 9.6 and 10.7 percent of the subjects had high total cholesterol levels and between 5.2 and 6.6 percent of subjects had high LDL cholesterol levels, the researchers report.

The authors calculate that about 0.8 percent of teenagers were potentially eligible to receive treatment for high LDL cholesterol.

"It is a matter of opinion whether one thinks 0.8 percent is a small or large percentage," Ford said. "What I think is most important here is that - given the rise in childhood obesity and risk factors such as smoking and lack of exercise that adolescents are exposed to - we need to continually assess and monitor the (cholesterol) status of children and adolescents."

SOURCE: Circulation, March 3, 2009.