Statins for Kids?--A Terrible Idea

Tuesday, July 8

I can just see it: "New! Cherry-flavored Lipitor! Why wait until you're 50? Start fighting cholesterol early, in elementary school!"

New guidelines posted yesterday by the American Academy of Pediatrics promise a bonanza for the failing pharmaceutical industry (Today, Merck, faced with unexpected resistance to its much vaunted Gardasil vaccine to prevent pre-pubescent girls from getting HPV infections, was down-graded by stock analysts).

Pediatric statins are the worst idea since those chocolate cigarettes they used to give us as kids!

Tara Parker Pope reports in the July 8, 2008 NY Times: "While some doctors applauded the idea, others were incredulous . . . 'To be frank, I'm embarrassed for the AAP today,' said Dr. Lawrence Rosen of Hackensack University Medical Center in New Jersey, vice chairman of an academy panel on traditional and alternative medicine. He added: 'Treatment with medications in the absence of any clear data? I hope they're ready for the public backlash'."

The new guidelines call for kids to be screened, as early as two where family history warrants, but no later than ten years of age. Low-fat diets are to be implemented "with two per cent milk" for kids with high cholesterol. But most controversial are the recommendations that call for powerful cholesterol reducing drugs to be used in the following cases:

Kids with LDL cholesterol greater than 190. But that's not all.

Kids with LDL cholesterol greater than 160 if any other risk factors are present like overweight, high blood pressure, family history of heart disease, or cigarette smoking [Junior's hooked on Camels, so make sure you put Zocor in his lunchbox!]

ALL children with diabetes whose LDL is greater than 130!

These ham-handed guidelines will insure that millions of kids are enrolled as lab rats in an experiment of unprecedented proportions!

While statins can help a limited number of older people with demonstrable cardiovascular disease, their use to prevent disease in otherwise healthy individuals is a total EXTRAPOLATION (Translation: a wild leap of faith). They seem to work best in people with high calcium scores or angina, after a heart attack, bypass or stent, and in middle aged men.

NO research shows they work in children, and it would take fifty years of careful study in thousands or even millions of kids to prove they provide one iota of benefit.

Cholesterol is actually essential for the developing brain. The brain is largely composed of cholesterol. Even in adults, a connection has been demonstrated between higher cholesterol--especially HDL--and better brain function. Whatýs bad for the ticker is good for the brain. Children's brains are rapidly growing and forming new nerve connections, and limiting cholesterol, either via an ultra-restrictive low-fat diet or through artificial cholesterol blockade might have unforeseeable effects on brain development.

Additionally, cholesterol is the building block for all the body's sex hormones: testosterone, estrogen, progesterone, DHEA, and even the adrenal hormone stress hormone, cortisol. Imagine the potential effects of limiting the availability of these on a child's normal maturation!

Not to mention the wide variety of statin side effects already recognized in adults that might take new, troubling forms in immature bodies: liver problems, muscle pains, mood and sleep problems, and memory deficits, to mention just a few of the more common ones.

And, since statins deplete CoEnzyme Q 10, which has a wide gamut of functions in cells, why aren't AAP pediatricians calling for universal prophylactic administration of supplemental CoQ 10 to those hapless children who will be exposed to statins' onslaught on their immature bodies? One of the theories behind susceptibility to autism is that it's a mitochondrial disease, and that's what Co Q 10 specifically governs.

Don't get me wrong--we should care about our kids risk of future disease--they're the future of our country, and unfortunately, of our stressed-to-the-breaking point health care system. High cholesterols should be just one of many warning signs that kids need corrective action, but not with drugs of unproven efficacy and safety. Meanwhile, kids with obesity, sedentary lifestyles and early tendency toward high blood pressure and diabetes should be targeted with boot-camp programs for risk reduction. I'd rather see public monies be expended on decisive lifestyle turnaround targeting kids (and their enabling parents), rather than creating a huge, unaffordable new drug entitlement so eight year olds can get statins.

The AAP pediatricians who promulgated these guidelines are either fat-heads ( a compliment, really, since the brain needs fat and cholesterol!), or else they themselves are suffering from statin-induced encephalopathy. At this early juncture, efforts to disclose that they are on the take from drug companies have yielded no obvious signs of unsavory ties, but just wait. Following the money trail recently revealed huge conflicts of interest on the part of researchers promoting powerful drugs for children with the newly-minted diagnosis of "childhood bipolar disease".

The new cholesterol guidelines and statin recommendations for kids are just typical of the paint-by numbers, mechanistic approach we take to medicine today.