Children ‘should take statins’
STATINS should be given to thousands of children by the age of 10 under radical new NHS guidance.
GPS are being urged to identify boys and girls with an inherited risk of high cholesterol, amid warnings that most cases go undetected.
Estimates suggest up to 260,000 people, including 50,000 children, suffer genetic defects that affect the body’s ability to break down cholesterol. Guidance issued by the National Institute for Health and Care Excellence (Nice) today says statins should be offered to reduce the risk of heart conditions or stroke in midlife.
Only 15 per cent of those with the condition are being treated, Nice said, including just 600 of 56,000 children with the genetic disorder.
Family doctors are being asked to trawl records to identify those with high cholesterol levels.
Where levels of more than 9 millimoles per litre (mmol/l) are found in those over 30, and levels of 7.5 mmol/l are found in those under 30, high-dose
statins should be offered, the NHS guidance says. It adds that gene tests should be used to find other family members, including those aged under 10, who are at such heightened risk they should be put on medication.
Around 56,000 children suffer familial hypercholesterolaemia (FH), yet just 600 have been diagnosed, according to charities. The condition gives men a 50 per cent chance of a heart attack or stroke before 50, while women have a one in three chance by 60. Siblings and children of those with the defects inherit a 50 per cent risk.
Prof Mark Baker, a director at Nice, said: “Familial hypercholesterolaemia is a serious, often undiagnosed but relatively common condition which, if treated early, ideally in childhood, will not affect life expectancy.
“Starting on the right treatment, usually with a high-intensity statin, as soon as possible is important, but only a fraction of people with the condition know they have it. It’s also important that family members of people diagnosed with FH are traced and offered a test to see if they have the condition.”
Around eight million people in the UK are on statins, and Nice guidance already suggests around 40 per cent of all adults should take the drug. The new advice is for those whose genetic risk is higher than average.
Prof Sir Nilesh Samani, medical director at the British Heart Foundation, said the guidance could save lives. “It’s disappointing that we have the ability to diagnose and treat people with FH, yet 85 per cent remain undiagnosed and at risk of a potentially fatal heart attack or stroke,” he said.
The charity Heart UK said the guidance did not go far enough and calling for a “national screening programme”.
Jules Payne, the chief executive, said: “GPS do not routinely carry out cholesterol tests in most patients until they reach the age of 40 when they are eligible for an NHS health check.
“Therefore there are many invisible patients with FH who are at risk.”