Certainly in adult medicine, persistent dyslipidemia may be countered with the addition of cholesterol-lowering drugs. Also, intrinsic to the decision to prescribe medications is a consideration of comorbidities such as diabetes, obesity, smoking, hypertension, along with knowledge of the patient’s pre-existing cardiovascular or peripheral vascular disease. Aside from the growing predisposition toward obesity, children rarely [...]

The first hurdle to clear is to identify who should be screened for hypercholesterolemia. Most practitioners agree on the American Heart Association’s recommendation of screening all children after two years of age who meet at least one of the following historical criteria:

any parent or grandparent with cardiovascular, cerebro-vascular, or peripheral vascular disease before age 55 [...]

Today, health care providers must ask themselves these questions:

Should we consider at-risk children for medical management with hypercholesterolemic drugs, particularly the class reputed to be the most effective, the HMG-CoA reductase inhibitors (statins)?
Should we recommend only lifestyle modification along with a low-fat or a low-carbohydrate diet and daily vigorous aerobic exercise?
Should we do neither—and possibly [...]

INTRODUCTION
Our children are being relentlessly exposed to a cardiotoxic environment. High calorically dense, fat-enriched foods, and technologically aided sedentary lifestyles predispose future generations to cardiovascular insult. An idea once considered unimaginable a generation ago, more and more children are developing risk factors for coronary artery disease at an alarming rate.