I sat nervously listening to the Lipid Clinic doctor describe the current recommendation that you start children with FH on statins at around the age of 10.
Many years ago I had discussed my son’s high cholesterol with my GP who had said ‘He will need to go on to medication at some stage, but the question is when’. At that time there was no suggestion of putting children on statins and as a result I had always thought of statins as an ‘adult’ medication and that he would go onto medication when he was older. This was adding to my dilemma of whether I should consider putting him on statins at the age of 11.
I went home and immediately searched the Internet (Dr Google I call it) and discovered that this was the recommended age in many countries for prescribing statins to children, although some prescribed them from an even younger age. I also read the FH Facebook page and the opinion of other parents was that early treatment with statins would significantly reduce the risk of any cardiovascular diseases.
For those of us with FH, we know we have high cholesterol levels from birth and we start laying down cholesterol (plaque) in our arteries from birth; this process is called atherosclerosis. It has been shown that by age 10, fatty streaks (the first stage of atherosclerosis) may be present. This evidence supports the argument for early treatment; the sooner treatment starts and lowers cholesterol, the sooner there is a decrease in the atherosclerotic process, thus decreasing the risk of early onset of cardiovascular disease specifically coronary artery disease.
Short-term studies have shown a decrease in the thickness of the carotid artery in children taking statins, although there has been no long-term studies on the effectiveness of treatment starting in childhood. There is no question that statins have led to significant reductions in heart attacks/disease in adults, which is strongly evident by my family history. My brother and I started taking statins when we were in our 20s and we have lived longer than our father (died at 35) who didn’t have the benefit of statins. I made the decision to put my son on statins when his DNA test came back positive. I hope that starting him on statins at an even earlier age will mean that he will have a normal life expectancy.
‘Data suggests that early treatment with statins will reduce risk to a level similar to those without FH… noting that early treatment is more effective at lowering LDL cholesterol than waiting until later in life’
I feel given our family history, my son’s high cholesterol levels, what I have read and the advice I have been given by the Lipid Clinic doctors, the decision to put my son on medication early was the right decision. You may feel differently about putting your child on medication; if you don’t have a strong family history of early heart disease/death or if you have side effects to statins – your decision is more difficult. Unfortunately most people with FH will require medication – for children the question is, when is the best time to start?
My son has been on statins for two years now and there seems to be no psychological or physiological effects from being diagnosed with FH or taking medication. He is under the care of a paediatrician in our children’s hospital.
I am thankful that an effective treatment for FH currently exists and that my family has been diagnosed and we are all receiving the best (world-class in fact) treatment available.
What does the future hold? There are lots of promising new treatments on the horizon and I am sure that my son won’t be on statins all his life; that there will be better alternatives for him in the not so distant future.