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Drug Therapy of Hypercholesterolaemia in Children and Adolescent

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Abstract

Cardiovascular disease (CVD) remains the leading cause of death and morbidity in the world. The origins of atherosclerosis and subsequent CVD begin in childhood. In order to prevent CVD, children and adolescents at high risk for premature atherosclerosis should be identified and treated as early as possible. Hypercholesterolaemia is a major risk factor for atherosclerosis. Childhood hypercholesterolaemia can be either primary, due to hereditary disorders such as familial hypercholesterolaemia (FH) and familial combined hyperlipidaemia (FCHL), or secondary due to obesity, diabetes mellitus or nephrotic syndrome.

Current guidelines suggest screening for hypercholesterolaemia between the ages of 2 and 10 years. Treatment strategies include lifestyle interventions involving dietary changes and increased physical activity. If these interventions are insufficient in lowering serum low-density lipoprotein cholesterol (LDL-C) levels, pharmacological therapy should be considered from the age of 8 years. Currently, statins are the preferred initial pharmacological therapy and have proven to be both efficient and well tolerated. However, long-term data on safety, and regular monitoring of those patients treated with statins, are still required, because in children with primary hypercholesterolaemia, treatment should be continued for life.

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No sources of funding were used to conduct this study or prepare this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this article.

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  1. Department of Pediatrics, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands

    Marjet J. A. M. Braamskamp, Frits A. Wijburg &  Albert Wiegman

  2. Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands

    Marjet J. A. M. Braamskamp

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Correspondence to Albert Wiegman.

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Braamskamp, M.J.A.M., Wijburg, F.A. & Wiegman, A. Drug Therapy of Hypercholesterolaemia in Children and Adolescent. Drugs 72, 759–772 (2012). https://doi.org/10.2165/11632810-000000000-00000

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