Current Cardiovascular Risk Reports

, Volume 7, Issue 4, pp 261–269 | Cite as

Pediatric Lipid Screening and Treatment for Cardiovascular Disease Prevention: An Ounce or a Pound?

  • Sarah D. de Ferranti
  • John B. Wong
  • Holly Gooding
  • Joshua T. Cohen
  • R. Christopher Sheldrick
  • Susan K. Parsons
  • Laurel K. Leslie
Pediatrics (S Gidding, Section Editor)

Abstract

Although cardiovascular disease (CVD) mortality is declining, atherosclerosis-related diseases remain the leading cause of death. With the next frontier of CVD prevention focused on youth, the 2011 NHLBI Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents called for universal lipid screening of children ages 9–11 and adolescents ages 17–21 years. While atherosclerosis is rarely clinically evident in childhood, childhood risk factors have been linked to adult CVD events. Clinical controversies about screening and treatment exist, in part due to incomplete evidence, the long latency period between screening and adult CVD outcomes and the lack of information available about patient, provider and parent values and preferences. We describe clinical controversies in lipid screening and treatment for specific pediatric populations, highlight knowledge gaps limiting guideline development and implementation and consider innovative approaches that will further inform this discussion.

Keywords

Cholesterol Dyslipidemia Screening Comparative effectiveness Decision analysis Statin 

Abbreviations

AAP

American Academy of Pediatrics

ATP

Adult Treatment Panel

CVD

Cardiovascular disease

LDL-C

Low-density lipoprotein cholesterol

FH

Familial hypercholesterolemia

HDL-C

High-density lipoprotein cholesterol

NHLBI

National Heart, Lung, and Blood Institute

PCORI

Patient-Centered Outcomes Research Institute

QoL

Quality of Life

RCT

Randomized controlled trial

TG

Triglycerides

USPSTF

US Preventive Services Task Force

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Sarah D. de Ferranti
    • 1
  • John B. Wong
    • 1
  • Holly Gooding
    • 1
  • Joshua T. Cohen
    • 1
  • R. Christopher Sheldrick
    • 1
  • Susan K. Parsons
    • 1
  • Laurel K. Leslie
    • 1
  1. 1.Department of CardiologyBoston Children’s HospitalBostonUSA

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