Hyperlipidemia in the pediatric patient:: Are statins indicated in children with hypercholesterolemia in the absence of a history of familial hypercholesterolemia

Problem: Children with high cholesterol are more likely to develop early onset coronary artery disease as an adult compared to children with healthy lipid levels. In spite of awareness and efforts of lifestyle modification, many children with hypercholesterolemia simply cannot get their lipid levels to decrease. Furthermore, there is minimal research on statin medication use in children with hypercholesterolemia without familial hypercholesterolemia. The purpose of this literature review is to determine if statins are safe and effective in children with hypercholesterolemia in the absence of familial hypercholesterolemia. Methods: A PubMed, AccessMedicine, UpToDate, and Harrison's search using the Weill Cornell Medical College Library was conducted for scholarly clinical trials that looked at the relationship between children with hypercholesterolemia and the use of statins to control lipid levels. Supplementary articles generated from this search were used for background information. Results: Seven review articles and three studies were selected from this literature review. The results of this research imply the use of statins in children with hypercholesterolemia is the most effective treatment with the fewest side effects when lifestyle modification fails. Conclusions: Clinical trials including statin use in children with hypercholesterolemia without FH are close to nonexistent but imperative to assess the safety and effectiveness of this class of drugs. Even the studies of medication in children with FH are rare and have small sample sizes. Prospective trials need to be performed utilizing statins in children with hypercholesterolemia without familial hypercholesterolemia.