Cholesterol-fighting medications are more typically associated with grumpy old men than grammar schoolchildren, but an influential medical group said children as young as 8 could be prescribed the meds.

Cholesterol-fighting medications are more typically associated with grumpy old men than grammar schoolchildren, but an influential medical group said children as young as 8 could be prescribed the meds.


In guidelines released Monday, the American Academy of Pediatrics said prescribing the medication to young children could help ward off later heart problems.


Doctors and medical experts, however, warned against parents rushing to put their children on the drugs.


"I hope people don't overreact," said Dr. Jerry Wortzman, chairman of the pediatrics department at MetroWest Medical Center in Framingham. "The first message should be that there are very few kids who would meet the recommended criteria for starting treatment."


Under the new guidelines, cholesterol-fighting drugs would be prescribed to children 8 or older who have too much LDL, the so-called "bad" cholesterol, along with other risky conditions, including obesity and high blood pressure.


Among children with too little HDL, the "good" cholesterol, the first course of action should be weight loss, more physical activity and nutritional counseling, the academy says.


The guidelines also recommend pediatricians regularly check the cholesterol of children with a family history of inherited cholesterol disease or with parents or grandparents who developed heart disease at early ages.


Screening also is advised for kids whose family history is not known and those who are overweight, obese or have other risk factors for heart disease.


The academy's earlier advice said cholesterol drugs should only be considered in children older than 10 after they fail to lose weight.


Because obesity is a risk factor for heart disease and often is accompanied by cholesterol problems, the academy also recommended giving low-fat milk to 1-year-olds.


In practice, Wortzman said, the recommendations mean only children with the most serious cholesterol problems might be prescribed medication.


"We actually find very few kids whose numbers are in those ranges," he said of the recommendations. "On the other hand, there's just so much evidence that cholesterol does bad things when it's in excess, and those bad things start in childhood, and people should be concerned about it."


For the vast majority of children, MetroWest Community Health Care Foundation President Martin Cohen emphasized, the age-old advice of making sure kids eat healthy and exercise is still the best.


"First of all, it's probably right, given what we see in terms of obesity and other things, the health risks to kids are greater earlier...but to think about a medication like that for a child is sad, because we should be doing more to prevent the presence of high cholesterol before it gets to that point.


"The alarm that goes off here should be one about the issue of lifestyle," he said. "For many - not for all - but for many, there are things we can change. The teachable moment here is not that I need to put my kids on Lipitor, the teachable moment is to help my kids...change their behavior."


Peter Reuell can be reached at 508-626-4428 or preuell@cnc.com.


The MetroWest Daily News