Statin drug works for teens with high cholesterol

For children who inherit a predisposition to high cholesterol levels, starting treatment early with a cholesterol-lowering statin drug slows the build-up of plaque in their arteries, according to a new report.

The hereditary condition, called familial hypercholesterolemia, is the result of a genetic defect in the mechanism for clearing LDL ("bad") cholesterol from the body. People with the condition have extremely high LDL cholesterol levels, which often leads to coronary artery blockages by early adulthood.

In a previous study, Dr. Barbara A. Hutten, from the Academic Medical Centre in Amsterdam, and her colleagues found that treating affected children between 8 and 18 years of age with pravastatin (also known by the brand name Pravachol) for 2 years slowed or reversed the thickening of the walls of the carotid artery in the neck, a sign of generalized atherosclerosis or plaque build-up in the arteries.

The goal of the present study, in the American Heart Association's journal Circulation, was to determine the best time for starting statin treatment based on the results in these patients.

After the initial trial, which compared the effect of pravastatin with an inactive placebo, all 214 children went on to treatment with either 20 or 40 milligrams of pravastatin each day depending on their age. Cholesterol was measured on a regular basis, and the wall thickness of the carotid artery was assessed after an average of 4.5 years.

The team found that the age when treatment started was linked to the artery wall thickness. Namely, the earlier pravastatin was initiated, the less progression was seen in thickening of the carotid wall.

"Our data support early initiation of statin therapy in familial hypercholesterolemic children, which might yield a larger benefit in the prevention of atherosclerosis later in life," Hutten said in a statement.

"In our opinion," she advised, "physicians should consider statin treatment for all familial hypercholesterolemic children who are 8 or older."

SOURCE: Circulation, August 7, 2007.