CME Article

Lipid Screening and Treatment Recommendations for Children and Adolescents

Patrick E. McBride, MD, MPH; Rae-Ellen W. Kavey, MD, MPH

  • Pediatric Annals
  • July 2012 - Volume 41 · Issue 7: 1-10
  • DOI: 10.3928/00904481-20120625-08
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Abstract

CME Educational Objectives

  1. Review basic lipid metabolism and the common dyslipidemias that can be diagnosed in childhood.

  2. Understand screening guidelines and when to initiate drug treatment.

  3. Know when referral to a lipid clinic is appropriate.

 

Atherosclerotic lesions begin in childhood, and the presence and progression of those lesions are associated with cardiovascular disease risk factors, including lipid dyslipidemias. The early identification and treatment of youth with cardiovascular disease (CVD) risk factors and dyslipidemias can alter the atherosclerotic process. The increasing incidence and prevalence of overweight and obesity in youth and the failure of targeted screening strategies, suggest universal lipid screening is necessary. Universal screening is recommended by recent NIH guidelines as part of a comprehensive approach to reducing atherosclerotic risk for youth. Screening goals include the identification of youth with abnormal lipid levels and/or inherited lipid disorders in order to focus lifestyle and treatment recommendations on those at highest risk for early CVD. The primary treatment for most children and adolescents with dyslipidemias is lifestyle change, including a diet low in total and saturated fat and cholesterol with appropriate calories for normal growth and development, weight control, and regular physical activity. Children with familial dyslipidemias, obesity, metabolic syndrome, and other medical problems which increase atherosclerotic risk, may also be candidates for pharmacologic therapy. The indications for lipid screening and for management, including use of medication for children with significant dyslipidemias, are reviewed.

AUTHORS

Patrick E. McBride, MD, MPH is Associate Dean of Students at the University of Wisconsin School of Medicine and Public Health; Director, University of Wisconsin Hospital and Clinics’ Preventive Cardiology Program; and Professor, University of Wisconsin School of Medicine, Department of Medicine, Section of Cardiovascular Medicine. Rae-Ellen W. Kavey, MD, MPH is Director of Clinical Research for the Division of Pediatric Cardiology, and Professor of Pediatrics at the University of Rochester Medical Center.

Disclosure: Drs. McBride and Kavey have no relevant financial relationships to disclose.

Address correspondence to: Patrick E. McBride, MD, MPH, UW School of Medicine and Public Health, 2150 Health Sciences Learning Center, 750 Highland Avenue, Madison, WI 53705-2221; email: pem@medicine.wisc.edu

doi: 10.3928/00904481-20120625-08

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