Lipid abnormalities in children: should we be doing more?

Julian G Ayer, David R Sullivan and Gary F Sholler
Med J Aust 2009; 190 (3): . || doi: 10.5694/j.1326-5377.2009.tb02304.x
Published online: 2 February 2009

Australia needs to develop its own guidelines based on local data

New guidelines for testing and treating lipid abnormalities in children have recently been published by the American Academy of Pediatrics and the American Heart Association (Box).1,2 These recommendations, made partly in response to the high prevalence of obesity in children in the United States, provoke consideration of whether they should also be adopted in Australia. The previous US recommendations,3 which targeted cholesterol testing to children with a family history of premature cardiovascular disease or high cholesterol levels, had focused on a population-based approach to treatment through a fat- and cholesterol-restricted diet. Drug therapy was reserved for children with more persistent and extreme elevations in cholesterol level. In contrast, the recent guidelines recommend that testing be broadened to include all overweight or obese children, with the first cholesterol assessment to be done between the ages of 2 and 10 years. The new guidelines further recommend that initiation of drug therapy be considered at a younger age (from 8 years) and with a lower low-density lipoprotein cholesterol (LDL-C) level target for children with multiple cardiovascular risk factors.

  • Julian G Ayer1
  • David R Sullivan2
  • Gary F Sholler1,3

  • 1 Adolph Basser Cardiac Institute, The Children’s Hospital at Westmead, Sydney, NSW.
  • 2 Royal Prince Alfred Hospital and School of Molecular and Microbial Biosciences, University of Sydney, Sydney, NSW.
  • 3 Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW.



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