A study published in JAMA Pediatrics has found that an additional 400,000 people aged 17–21 with elevated low-density lipoprotein cholesterol (LDL-C) levels could be eligible for statin treatment under pediatric guidelines compared to adult guidelines.
Holly C. Gooding, MD, MSc, of Boston Children’s Hospital, and colleagues evaluated data from the National Health and Nutrition Examination Survey (NHANES) over the time period of January 1999 to December 2012, comparing the proportion of young people aged 17–21 years who met criteria for pharmacologic treatment of elevated LDL-C levels under pediatric vs. adult guidelines.
Of the 6,338 individuals in this population, 2.5% would qualify for statin treatment under the pediatric guidelines compared to 0.4% under the adult guidelines. After extrapolating to the U.S. population of this age group, 483,500 individuals would be eligible for statin treatment under the pediatric guidelines while only 78,200 would qualify under the adult guidelines. Those who met the pediatric criteria had lower average LDL-C levels compared to the adult guidelines (167 vs. 210mg/dL, respectively) but had higher proportions of other cardiovascular risk factors including hypertension, smoking, and obesity.
The authors add that the actual number treated is likely to be much lower due to less than universal screening in this age group, challenges with adherence to medication regimens, and clinician or patient disagreement with the recommendations. Shared decision making between clinicians and patients on the potential benefits and harms of statin therapy is recommended.
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