Wise or Not? Doctors Sound Off on Cholesterol Tests for Kids

Like millions of Americans, Connor Kroll of Oak Ridge, N.J., takes the cholesterol-busting drug Lipitor. And like many others, he has reaped the medicine's benefits; in the four years he has been taking it, his dangerously high cholesterol levels have been cut nearly in half.

But Kroll stands out from the typical patient on statin drugs, like Lipitor, in one important way. He is only 16 years old.

"I'm not crazy about medications, but nothing else worked," Kroll's mother Audrey told ABC News correspondent John McKenzie. "He tried a very strict diet, and that was just not enough."

Indeed, cholesterol screening, drugs and diets have traditionally been the unwelcome chores of middle age. But for the first time, doctors with the American Academy of Pediatrics are recommending such health measures for a greater number of young children.

Under the guidelines, some 2-year-olds would receive cholesterol tests, and some children as young as 8 would take the cholesterol-lowering drugs called statins.

Reaction from doctors, both in favor of and against the move, is passionate. At stake are rising health care costs and precious time from physicians, as well as a growing obesity epidemic that is feeding America's No. 1 killer: heart disease.

"It is long past due," said Dr. Wesley Covitz, professor of cardiology and director of pediatric lipid and metabolic syndrome clinics at Wake Forest University Health Sciences in Winston Salem, N.C. "There has been a complacency among pediatric providers relevant to screening for high cholesterol," he said.

The last AAP policy in 1998 only recommended screening of children who have a family history of heart problems or rare, inherited cholesterol disorders. The new guidelines would expand cholesterol screening to all children who have body mass indexes in the 95th percentile, along with other issues, such as high blood pressure. The guidelines also lower the minimum age for cholesterol medication from 10 to 8 years old.

"I'm glad to see the pediatricians give the go-ahead to screen kids earlier and prevent these horrible problems," said Dr. Gerald Fletcher, a cardiologist and professor of medicine at the Mayo Clinic in Jacksonville, Fla. "It's nothing but a finger prick to do the screen."

But some doctors, who are equally concerned with weight and lifestyle issues, don't believe the AAP recommendations are the best way to proceed.

"This is overkill for a problem which rarely causes clinical problems before age 40, and is effectively treatable if measures are initiated in the 30 to 40 age range, or later," said Dr. Bruce Gregory Brown, professor of cardiology at the University of Washington in Seattle.

"The cost of widespread implementation of the AAP recommendations would far exceed their benefits in terms of general health effects," he said.

Brown also wonders whether statins will have a detrimental effect during puberty, when hormone levels are more sensitive to LDL cholesterol.

"While the evidence for safety of statins in the adult population is quite good, with over 20 years experience, there has not been a large experience for safety in children," Brown said. "However, the available evidence looks safe."

Whichever way doctors or parents view the new recommendations, the studies and information that prompted the policy overhaul draw concern across the board.

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