Family history of cardiovascular events and endothelial dysfunction in children with familial hypercholesterolemia

Jongh, Saskia de; Lilien, Marc R.; Bakker, Henk D.; Hutten, Barbara A.; Kastelein, John J.P.; Stroes, Erik S.G.

doi:10.1016/s0021-9150(02)00003-5

Cited by 125 publications

(55 citation statements)

References 27 publications

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“…Adolescents with a positive family history of cardiovascular events have lower FMD than do control subjects, with further reduction seen in children with FH. 290 These abnormalities are not restricted to the more severe FH cases but are also found in children with familial combined hyperlipidemia. 267 It is not clear, however, whether these changes can be related directly to LDL cholesterol levels.…”

Section: Data In Children and Adolescentsmentioning

confidence: 98%

Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents

Urbina

Williams²,

Alpert³

et al. 2009

Hypertension

554

274

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Abstract-Deterioration in endothelial function and arterial stiffness are early events in the development of cardiovascular diseases. In adults, noninvasive measures of atherosclerosis have become established as valid and reliable tools for refining cardiovascular risk to target individuals who need early intervention. With limited pediatric data, the use of these techniques in children and adolescents largely has been reserved for research purposes. Therefore, this scientific statement was written to (1) review the current literature on the noninvasive assessment of atherosclerosis in children and adolescents, (2) make recommendations for the standardization of these tools for research, and (3) stimulate further research with a goal of developing valid and reliable techniques with normative data for noninvasive clinical evaluation of atherosclerosis in pediatric patients. Precise and reliable noninvasive tests for atherosclerosis in youth will improve our ability to estimate future risk for heart attack and stroke. Currently, large longitudinal studies of cardiovascular risk factors in youth, such as the Bogalusa and Muscatine studies, lack sufficient adult subjects experiencing hard outcomes, such as heart attack and stroke, to produce meaningful risk scores like those developed from Framingham data.

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Section: Data In Children and Adolescentsmentioning

confidence: 98%

Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents

Urbina

Williams²,

Alpert³

et al. 2009

Hypertension

554

274

View full text Add to dashboard Cite

show abstract

“…Ezetimibe, the first in a new class of cholesterol absorption inhibitors, may provide additional efficacy in homozygous FH. more decades [5], but may be more rapid when coronary risk factors other than hypercholesterolemia are present [6][7][8][9]. Another monogenic form of hypercholesterolemia similar to, but usually milder than, heterozygous FH is familial defective apolipoprotein B-100 (FDB).…”

Section: Opinion Statementmentioning

confidence: 99%

Management of hyperlipidemia in the pediatric population

Tonstad

Thompson²

2004

Curr Treat Options Cardio Med

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Heterozygous familial hypercholesterolemia (FH) affects one in every 500 persons and is the most common cause of markedly elevated cholesterol levels in children. Other causes of primary hyperlipidemia include familial combined hyperlipidemia, which is also common (approximately 1%) but not usually manifest until after puberty, and very rare genetic disorders that may lead to severe hypertriglyceridemia and chylomicronemia syndrome. In children with heterozygous FH, the short-term risk of clinical events is low; therefore, management starts with stratification of risk, followed by dietary modification, and in high-risk cases, pharmacologic treatment initiated after puberty. Male gender, a family history of premature coronary heart disease, and level of low-density lipoprotein (LDL) cholesterol above 4.9 mmol/L are important determinants of risk. Trials have shown that statins effectively lower LDL cholesterol levels; in one study, statins restored endothelial function, with no clinically adverse effects. The effects of statins for longer than 2 years have not been studied. The use of bile acid sequestrants (resins) is limited by compliance and side effects. Children with homozygous FH require expert management with LDL apheresis, high doses of effective statins, and cardiologic follow-up. Ezetimibe, the first in a new class of cholesterol absorption inhibitors, may provide additional efficacy in homozygous FH.

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“…Despite the absence of complaints or symptoms, functional and morphological changes of the arterial wall are already observed in children with FH, which indicates that the atherosclerotic process has already been initiated [2,3]. These findings have led to the hypothesis that treatment should be initiated early in life to reduce the incidence of CHD in later years.…”

Section: Familial Hypercholesterolemiamentioning

confidence: 99%

Novel pharmacological treatments for children and adolescents with heterozygous familial hypercholesterolemia

Wiegman

Hutten

2017

Expert Review of Clinical Pharmacology

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Family history of cardiovascular events and endothelial dysfunction in children with familial hypercholesterolemia

Cited by 125 publications

References 27 publications

Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents

Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents

Management of hyperlipidemia in the pediatric population

Novel pharmacological treatments for children and adolescents with heterozygous familial hypercholesterolemia

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