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It’s common for adults to take cholesterol-lowering drugs. But doctors say, in some cases, teens may need this medicine as well.

17-year-old Josh Lewis and his sister Abbey, for example, are thin and athletic – yet they both have high cholesterol.

“You can’t tell by looking at a kid how healthy or unhealthy they are on the inside,” says their mom, Sydney Ruben-Lewis.

“I wasn’t eating a lot of like greasy foods or anything,” says Josh. “I was like, ‘I have high cholesterol? What does that mean?’”

“I was told that you can have heart disease,” says 15-year-old Abbey, “heart attacks, you could die early. And that’s kind of a scary thought.”

Doctors say 30 percent of U.S. teens have high cholesterol. Poor diet is one reason: another is genetics.

“Those with very high cholesterol tend to be children who are born into families where there is an abnormality in metabolism of cholesterol,” says pediatric cardiologist Dr. Jack Stevens. “And the people with really the higher cholesterols, tend to have genetic or metabolic defects that lead to elevated cholesterol.”

Over time, cholesterol can lead to clogged arteries.

“What we are talking about with elevated cholesterol is the likelihood that we have coronary artery disease,” says Dr. Stevens, “hardening of the arteries, deposition of the fat in the arteries, some of the things we refer to, occurring starting in childhood, continuing in the teenage years.”

That means teens with high cholesterol could have heart attacks much earlier- in their 20’s and 30’s, instead of their 50’s or 60’s.

“The first treatment that has been recommended for all people with hypercholesterolemia,” says Dr. Stevens, “and has been recommended for really all Americans, is to try to cut saturated fats in the diet.”

But if that doesn’t work, cholesterol-lowering drugs may be an option – especially for teens with a family history.

“If there is a family history of early coronary artery disease in the parents, grandparents, or the aunts and uncles, than the child should undergo a lipid profile,” says Dr. Stevens.

Abbey and Josh both take the drugs: their cholesterol levels have dropped.

“I’m very glad I’m taking it,” says Abbey, “because I know in the long run, even though I can’t tell now, it’ll help me a lot.”

What We Need To Know

• Children with high cholesterol should switch to a high fiber diet, including plenty of fruits and vegetables. Children should also cut down on saturated fats. (Jack Stevens, M.D., Pediatric Cardiologist, Children’s Healthcare of Atlanta)
• Kids with LDL (bad cholesterol) levels above 190 may be candidates for cholesterol-lowering drugs. Try drugs only if the child’s cholesterol does not come down with diet and exercise.
  (Jack Stevens, M.D., Pediatric Cardiologist, Children’s Healthcare of Atlanta)
• Children with LDL (bad cholesterol) levels above 160 may be candidates for cholesterol-lowering drugs if they also have additional risk factors: a family history of heart disease, poor compliance with diet and exercise, being overweight, or hypertension. (Dr. Jack Stevens, M.D., Pediatric Cardiologist, Children’s Healthcare of Atlanta)

Resources

• American Heart Association
• National Institutes of Health

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