Hyperlipidemia NCEP recommendations for drug therapy of high-risk hyperlipidemia in children and adolescents: Difference between revisions
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(/* Original Recommendations of the National Cholesterol Education Program (NCEP) Expert Panel for Drug Therapy of High-Risk Hyperlipidemia in Children and Adolescents {{cite journal| author=McCrindle BW, Urbina EM, Dennison BA, Jacobson MS, Steinberg) |
(/* Original Recommendations of the National Cholesterol Education Program (NCEP) Expert Panel for Drug Therapy of High-Risk Hyperlipidemia in Children and Adolescents {{cite journal| author=McCrindle BW, Urbina EM, Dennison BA, Jacobson MS, Steinberg) |
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==Current Modifications== | ==Current Modifications== | ||
* In addition to family history, overweight and obesity should trigger screening with a fasting lipid profile. | * In addition to family history, overweight and [[obesity]] should trigger screening with a fasting [[lipid profile]]. | ||
* Overweight and obese children with lipid abnormalities should be screened for other aspects of the metabolic syndrome (i.e., insulin resistance and type 2 diabetes, hypertension, or central adiposity). | * [[Overweight]] and obese children with lipid abnormalities should be screened for other aspects of the [[metabolic syndrome]] (i.e., [[insulin resistance]] and [[type 2 diabetes]], [[hypertension]], or [[central adiposity]]). | ||
* For children meeting criteria for starting lipid-lowering drug therapy, a statin is recommended as first-line treatment. | * '''For children meeting criteria for starting lipid-lowering drug therapy, a [[statin]] is recommended as first-line treatment'''. | ||
* For children with high-risk lipid abnormalities, the presence of additional risk factors or high-risk conditions may also lower the recommended cutpoint LDL cholesterol level for initiation of drug therapy, lower the desired target LDL cholesterol levels, and in selected cases, may prompt consideration for initiation below the age of 10 years. These risk factors and high-risk conditions may include: | * For children with high-risk lipid abnormalities, the presence of additional risk factors or high-risk conditions may also lower the recommended cutpoint LDL cholesterol level for initiation of drug therapy, lower the desired target LDL cholesterol levels, and in selected cases, may prompt consideration for '''initiation below the age of 10 years'''. These risk factors and high-risk conditions may include: | ||
** Male gender | ** Male gender | ||
** Strong family history of premature cardiovascular disease or events | ** Strong family history of [[premature cardiovascular disease]] or events | ||
** Presence of associated low high-density lipoprotein (HDL), high triglycerides, small dense LDL | ** Presence of associated '''low [[high-density lipoprotein]] ([[HDL]]), high [[triglycerides]], small dense [[LDL]]''' | ||
** Presence of overweight or obesity and aspects of the metabolic syndrome | ** Presence of overweight or obesity and aspects of the metabolic syndrome | ||
** Presence of other medical conditions associated with an increased atherosclerotic risk such as diabetes, human immunodeficiency virus (HIV) infection, systemic lupus erythematosus, organ transplantation, survivors of childhood cancer | ** Presence of other medical conditions associated with an increased atherosclerotic risk such as [[diabetes]], [[human immunodeficiency virus]] (HIV) infection, [[systemic lupus erythematosus]], organ [[transplantation]], survivors of childhood [[cancer]] | ||
** Presence of hypertension | ** Presence of [[hypertension]] | ||
** Current smoking and passive smoke exposure | ** Current [[smoking]] and passive smoke exposure | ||
** Presence of novel and emerging risk factors and markers, e.g., elevated lipoprotein(a), homocysteine, C-reactive protein | ** Presence of novel and emerging risk factors and markers, e.g., elevated lipoprotein(a), [[homocysteine]], [[C-reactive protein]] | ||
* Ongoing research of drug therapy of high-risk lipid abnormalities in children is needed, particularly with regard to long-term efficacy and safety, and impact on the atherosclerotic disease process. | * Ongoing research of drug therapy of high-risk lipid abnormalities in children is needed, particularly with regard to long-term efficacy and safety, and impact on the atherosclerotic disease process. | ||
}} | }} |
Revision as of 14:30, 29 October 2011
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Children and adolescents with high-risk hyperlipidemia require lipid-lowering drug therapy, particularly those with familial hypercholesterolemia, despite compliance with lifestyle recommendations .
NCEP recommendations for drug therapy of high-risk hyperlipidemia in children and adolescents
Original Recommendations of the National Cholesterol Education Program (NCEP) Expert Panel for Drug Therapy of High-Risk Hyperlipidemia in Children and Adolescents [1] (DONOT EDIT)
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Current Modifications
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References
- ↑ McCrindle BW, Urbina EM, Dennison BA, Jacobson MS, Steinberger J, Rocchini AP; et al. (2007). "Drug therapy of high-risk lipid abnormalities in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee, Council of Cardiovascular Disease in the Young, with the Council on Cardiovascular Nursing". Circulation. 115 (14): 1948–67. doi:10.1161/CIRCULATIONAHA.107.181946. PMID 17377073.