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.