In a sweeping set of new guidelines designed to protect children from future heart disease, a panel of experts convened by the government recommended yesterday that all children have a cholesterol screening blood test between the ages of 9 and 11.
The intent is to identify children early on who are at risk of heart disease as adults and encourage them to change their diet and get more exercise, but critics said they feared many children would also be placed on drugs to lower cholesterol.
The panel said the latest evidence suggests that control of high cholesterol levels throughout childhood will substantially reduce heart disease risk later in life.
“We came up with these new guidelines based on a number of studies showing that the current approach to cholesterol screening misses children with substantially elevated levels who could benefit from changing their diet or increasing their physical activity,’’ said Dr. Stephen Daniels, chairman of the panel that reviewed the guidelines and pediatrician-in-chief at Children’s Hospital Colorado.
But some doctors say they worry that a greater number of children will be put on cholesterol-lowering statins at younger ages - and possibly kept on them for years or decades without knowing what benefits or long-term risks they would incur from the drugs. Some people experience muscle pain and liver problems from taking statins. In rare cases, life-threatening muscle damage can occur.
“The guidelines aren’t well thought out and represent an irrational exuberance for testing,’’ said Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic. He pointed out that no studies have been performed to show that universal cholesterol screening improves health outcomes in children.
Daniels responded that the intent of the guidelines is to identify children who have a genetic predisposition to elevated cholesterol, and these youngsters are not necessarily obese or inactive. If the guidelines are followed, he added, fewer than 1 percent of children screened would be eligible for medication. “The concept that this will lead to many, many children being treated with a pharmacologic agent is wrong,’’ he said.
The guidelines were issued by a panel of hospital- and university-based physicians convened by the National Heart, Lung, and Blood Institute and were published online by Pediatrics, the journal of the American Academy of Pediatrics. Several members of the panel disclosed financial relationships with pharmaceutical firms that manufacture statins.