Kids on Statins: Unethical or Sensible?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
Posted on

Two very different sets of guidelines exist for when to use cholesterol lowering medications in children transitioning into adulthood. Should those aged 17 – 21 with high cholesterol be on a cholesterol-lowering drug—a statin drug? How and when to treat those younger than 40, and especially those folks 17 – 21, is not nearly as well studied as in older folks, so guidelines are based on expert recommendations from limited data in this age group.

A recent study in JAMA Pediatrics found that if guidelines for the pediatric population from the National Heart, Lung, and Blood Institute (NHLBI) were followed, 400,000 more 17-21 year olds would be on statin therapy. 400,000! Sound crazy? Let’s take a look.

The Players:
2013 ACC/AHA guidelines (aka the “adult guidelines) vs 2011 NHLBI guidelines (aka the “pediatric guidelines”)

Similar recommendations:

Where the NHLHI guidelines for those aged 17 – 21 differ:

If we followed the NHLBI guidelines listed above, according to this recent study, almost half a million kids aged 17-21 would be on statin drugs (atorvastatin, simvastatin, Crestor). As an adult medicine doctor I can tell you: on this, we do not all agree.

What can we all agree on? Optimizing diet, exercise, and weight and promoting tobacco cessation.

Kids on statins . . . discuss.

Dr O.

Drugs featured in this story

Filed under