Starting statin therapy as young as age 8 safely and effectively delays the early artery damage caused by familial hypercholesterolemia (FH), according to a Dutch study reported in the Aug. 7th print issue of Circulation: Journal of the American Heart Association.
Our data support early initiation of statin therapy in FH children, which might yield a larger benefit in the prevention of atherosclerosis later in life, said Barbara A. Hutten, Ph.D., senior author of the study. In our opinion, physicians should consider statin treatment for all FH children who are 8 or older.
FH leads to severely elevated levels of low-density lipoprotein (LDL) cholesterol, commonly called bad cholesterol, beginning at birth. The result is an early thickening of the artery walls, premature cardiovascular disease (5 percent by age 30; 50 percent by age 50), and an increased risk of early heart attack, Hutten said.
The disorder also interferes with normal artery functioning. Dilation is reduced in children with FH, which reflects an increased stiffness of the vessel wall. This is the first sign of atherosclerosis, said Dr. Hutten, an assistant professor of clinical epidemiology at the University of Amsterdams Academic Medical Centre in the Netherlands.
When Hutten and colleagues began their long-term trial, several previous studies had demonstrated the short-term safety of statins in FH children. But none of them had followed patients for more than 48 weeks.
Researchers enrolled 214 children between ages 8 and 18 into the single-center, randomized, double-blind, placebo-controlled study at the Academic Medical Centre. Participants were admitted if they had one parent with a clinical or molecular diagnosis of FH and met other criteria, including elevated LDL.
The children were randomized to receive the drug pravastatin or placebo for two years. Those younger than 14 received 20 milligrams (mg) of the statin daily, and those 14 or older received a 40
Contact: Cathy Lewis
American Heart Association