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About atherosclerosis

Atherosclerosis is when the arteries become hardened or blocked by cholesterol and other lipids, which can lead to heart disease, heart attacks and strokes. Atherosclerosis occurs in adults, but its roots begin in the pediatric age range.  In particular, there's a disease called familial hypercholesteremia, which is a strongly inherited condition of high cholesterol that is present even at birth. These children can be at risk for developing heart disease, and having heart attacks, in their 30s and 40s. (The typical age this would usually occur is over 60.)

Familial hypercholesteremia is very common, affecting up to half a percent of the population, but it’s often not caught early. There's now a great push to try to identify these individuals and treat them sooner—which is why most pediatricians test their patients’ cholesterol.  If familial hypercholesteremia is identified, or if less severe elevations of cholesterol or triglycerides (often in association with obesity) are identified, pediatricians can refer these children to Cohen Children’s.

Our approach

The Cohen Children’s Pediatric Atherosclerosis Prevention Program is a collaborative program that uses the resources of our Division of Gastroenterology and Nutrition, as well as our Division of Cardiology. Our experts treat myriad children with cholesterol or triglyceride problems, regardless of the cause. During the initial visit, we go over the child’s family history and perform an examination and laboratory evaluation to discover the causes of elevated cholesterol/triglycerides. Most importantly, our dedicated nutritionists provide lifestyle counseling, including diet and exercise counseling. There is usually at least a six month trial period to see the effect of lifestyle modification.

If after this period of time, the child is firmly diagnosed with familial hypercholesterolemia or other severe elevation of cholesterol, then medication (called statins) will be considered if they are at least 8 to 10 years old.  These children are evaluated in the Cardiology Center with noninvasive testing before the start of medication. When medication is used, it is initiated at the lowest possible dose and followed every four to five weeks to check if it’s working and raise the dose if necessary. Once we achieve the optimal results, we follow up with the child every six months and check their progress.

Treating pediatric patients with familial hypercholesteremia doesn’t just help children. It has an added benefit for public health because often we find that many of the patients’ adult family members have the same disease and are not being treated. We encourage these individuals to get screened and get treated to prevent larger problems down the road, and we have the resources within Northwell Health to help them.

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