High cholesterol - children
Cholesterol is a fat (also called a lipid) that the body needs to work properly. There are many types of cholesterol. The ones talked about most are:
Too much bad cholesterol can increase the chance of getting heart disease, stroke, and other problems.
This article is about high cholesterol in children.
Lipid disorders - children; Hyperlipoproteinemia - children; Hyperlipidemia - children; Dyslipidemia - children; Hypercholesterolemia - children
Most children with high cholesterol have one or more parent who has high cholesterol. The main causes of high cholesterol in children are:
Certain health conditions can also lead to abnormal cholesterol, including:
Several disorders that are passed down through families lead to abnormal cholesterol and triglyceride levels. They include:
Exams and Tests
A cholesterol test is done to diagnose high blood cholesterol.
Guidelines from the National Heart, Lung, and Blood Institute recommend screening all children for high cholesterol:
However, not all expert groups recommend screening all children and instead focus on screening children at higher risk. Factor that increase a child's risk include:
General targets for children are:
If cholesterol results are abnormal, children may also have other tests such as:
Your child's provider also may ask about a medical or family history of:
The best way to treat high cholesterol in children is with diet and exercise. If your child is overweight, losing excess weight will help treat high cholesterol. But you should not restrict your child's diet unless your child's health care provider recommends it. Instead, offer healthy foods and encourage physical activity.
DIET AND EXERCISE
Help your child make healthy food choices by following these guidelines:
Encourage your child to be physically active. Children ages 5 years and older should be active at least 1 hour a day. Other things you can do include:
Other steps include teaching children about the dangers of tobacco use.
Your child's provider may want your child to take medicine for cholesterol if lifestyle changes do not work. For this the child must:
Children with very high cholesterol may need to start these medicines earlier than age 10. Your child's doctor will tell you if this may be needed.
There are several types of drugs to help lower blood cholesterol levels. The drugs work in different ways. Statins are one kind of drug that lowers cholesterol and has been proven to reduce the chance of heart disease.
High cholesterol levels can lead to hardening of the arteries, also called atherosclerosis. This occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard structures called plaques.
Over time, these plaques can block the arteries and cause heart disease, stroke, and other symptoms or problems throughout the body.
Disorders that are passed down through families often lead to higher cholesterol levels that are harder to control.
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Daniels SR, Couch SC. Lipid disorders in children and adolescents. In: Sperling MA, ed. Pediatric Endocrinology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 23.
Park MK. Dyslipidemia and other cardiovascular risk factors. In: Park MK, ed. Park's Pediatric Cardiology for Practitioners. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 33.
Stanley CA, Bennett MJ. Defects in metabolism of lipids. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 86.
US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for lipid disorders in children and adolescents: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;316(6):625-633 PMID: 27532917 www.ncbi.nlm.nih.gov/pubmed/27532917.
Review Date: 8/5/2018
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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