December 2010. Volume 6. Number 4

In children with hypercholesterolemia there is a lack of evidence regarding when to initiate pharmacologic therapy or what target low-density lipoprotein should be attained

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Lebenthal Y, Horvath A, Dziechciarz P, Szajewska H, Shamir R. Are treatment targets for hypercholesterolemia evidence based? Systematic review and meta-analysis of randomised controlled trials. Arch Dis Child. 2010;95:673-80
Reviewers: Velarde Mayol C1, González Rodríguez MP2.
1CS de Segovia 1. Segovia. España.
2CS Barrio del Pilar. Área 5. Madrid. España.
Correspondence: Cristina Velarde Mayol. Email: cvelardemayol@yahoo.es
Reception date: 21/10/2010
Acceptance date: 02/11/2010
Publication date: 04/11/2010

Abstract

Authors´ conclusions: in children with familial hypercholesterolemia there is no firm evidence regarding when to start statins treatment or what target low-density lipoprotein (LDL-c) cholesterol level should be attained.

Reviewers´ commentary: hypercholesterolemia  is one of the main cardiovascular risk factors in adults, that often begins during  chilhood. However, there is no clear association between lipid levels in  children and its consequences in adulthood. In children, in short term studies, therapy with statins reduces total cholesterol and LDL-c, with no action on other risk parameters. Because it is not defined the age to initiate the therapy, nor the  duration, nor the levels to achieve, and without knowing the long-term adverse effects, statin therapy in children should be prescribed with caution. Interventions should be aimed to dietary modifications, weight control, physical inactivity and smoking prevention.

How to cite this article

Velarde Mayol C, González Rodríguez MP. En niños con hipercolesterolemia, no existe evidencia de cuándo empezar el tratamiento farmacológico ni de cuál es el nivel óptimo de lipoproteínas que se debe alcanzar. Evid Pediatr. 2010;6:86.

AVC | Critically appraised articles

Lebenthal Y, Horvath A, Dziechciarz P, Szajewska H, Shamir R. Are treatment targets for hypercholesterolemia evidence based? Systematic review and meta-analysis of randomised controlled trials. Arch Dis Child. 2010;95:673-80
Reviewers: Velarde Mayol C1, González Rodríguez MP2.
1CS de Segovia 1. Segovia. España.
2CS Barrio del Pilar. Área 5. Madrid. España.
Correspondence: Cristina Velarde Mayol. Email: cvelardemayol@yahoo.es
Reception date: 21/10/2010
Acceptance date: 02/11/2010
Publication date: 04/11/2010

How to cite this article

Velarde Mayol C, González Rodríguez MP. En niños con hipercolesterolemia, no existe evidencia de cuándo empezar el tratamiento farmacológico ni de cuál es el nivel óptimo de lipoproteínas que se debe alcanzar. Evid Pediatr. 2010;6:86.

References

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  2. Cortés Rico O. Cribado de la hipercolesterolemia. En: Recomendaciones PrevInfad / PAPPS [en línea]. [Fecha de actualización: IV-2008; fecha de consulta: 17-X-2010]. Disponible en http://www.aepap.org/previnfad/colesterol.htm.
  3. Daniels SR, Greer FR. Committee on Nutrition. Lipid screening and cardiovascular health in childhood. Pediatrics. 2008;122:198-208.
  4. O'Gorman CS, Higgins MF, O'Neill MB. Systematic review and metaanalysis of statins for heterozygous familial hypercholesterolemia in children: evaluation of cholesterol changes and side effects. Pediatr Cardiol.2009;30:482-9.
  5. Vuorio A, Kuoppala J, Kovanen PT, Humphries SE, Strandberg T, Tonstad S et al. Statins for children with familial hypercholesterolemia. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD006401. DOI: 10.1002/14651858.CD006401.pub2.
  6. De Ferranti S, Ludwig DS. Storm over statin. The controversy surrounding pharmacology treatment of children. N Engl J Med. 2008;359:1309-12.

04/11/2010

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