1st April 2007
American Heart Association
Summary, Abstract,

Source: National Guidelines Clearinghouse

GUIDELINE OBJECTIVE(S)

To examine new evidence on the association of lipid abnormalities with early atherosclerosis, discuss challenges with previous guidelines, and highlight results of clinical trials with statin therapy in children and adolescents with familial hypercholesterolemia or severe hypercholesterolemia

TARGET POPULATION

Children and adolescents with high-risk lipid abnormalities

INTERVENTIONS AND PRACTICES CONSIDERED

Assessment

1. Risk factor assessment
2. Fasting lipid profile (in overweight and obese children)
3. Screening for other aspects of the metabolic syndrome (i.e., insulin resistance and type 2 diabetes, hypertension, or central adiposity [in overweight and obese children])

Treatment

Drug Therapy

1. 3-hydroxy-3-methylglutaryl-coenzyme A (HMG CoA) reductase inhibitors (statins)
2. Bile acid-reducing resins
3. Fibric acid derivatives
4. Nicotinic acid (extended release)
5. Cholesterol absorption inhibitors

Adjuvant Therapies

1. Physical activity
2. Nonpharmacologic therapies including fat- and cholesterol-restricted diets and dietary supplements

Management

1. Patient selection, initiation and titration, and monitoring of HMG CoA reductase inhibitors in children and adolescents with hyperlipidemia
2. Drug therapy of high-risk hyperlipidemia in children and adolescents

MAJOR OUTCOMES CONSIDERED

Change in levels of:

• Total cholesterol
• Low-density lipoprotein
• High-density lipoprotein
• Triglycerides
• Non-invasive vascular markers