Eight-year-olds 'could be given cholesterol drugs'

Children as young as eight should be given the cholesterol-lowering drugs statins to reduce their risk of heart disease, say doctors.

A week after the Government's heart adviser caused controversy by suggesting every man over 50 and every woman over 60 should take a daily statin, researchers in the Netherlands recommend that the medication should be offered to children at high risk.

But unlike Professor Roger Boyle, who argued that a blanket approach to treatment of heart disease in middle age would be the most effective strategy, the Dutch researchers do not suggest handing out statins so freely.

They recommend the treatment only for those children with a genetic condition called familial hypercholesterolemia (FH), which causes very high levels of low density lipoprotein cholesterol, commonly called "bad" cholesterol, from birth onwards.

Children with the condition show early signs of thickening of the artery walls and one in 20 has heart disease by the age of 30, with half suffering it by 50.

In the first long-term trial of statins in children, Barbara Hutten and colleagues from the University of Amsterdam's Academic Medical Centre randomly gave the drug or a placebo to 214 children, between eight and 18, with the condition.

After two years, the children receiving the placebo were switched to the active drug because the results were impressive.

Dr Hutten said: "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. In our opinion, physicians should consider statin treatment for all FH children who are eight or older."

Ultrasound scans were used to measure the wall thickness of the carotid artery in the neck - a recognised method of checking the narrowing of blood vessels. The findings, published in Circulation, the journal of the American Heart Association, showed that the earlier statin therapy was started the less the arteries thickened. The researchers say that the artery wall would grow 0.003 millimetres thicker for every year that the start of treatment was delayed.

The children were treated for at least 2.1 years and the longest for up to 7.4 years. No serious side-effects were found but the trial was too small to be sure about the safety of the treatment and the researchers said further trials were necessary.

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