Dyslipidemia

Dyslipidemia is a condition in which the bloodstream contains abnormal levels of fats, called lipids. High cholesterol, known as hyperlipidemia, is a type of dyslipidemia.

Dyslipidemia can cause hard, fatty deposits to accumulate in the blood vessels over time. This increases the risk of heart disease in adulthood. In the United States, at least 20% of adolescents have dyslipidemia. Studies show that many young and middle-aged adults with heart disease may have had untreated dyslipidemia as children.

Dyslipidemia may include one or more of the following:

• High levels of low-density lipoprotein cholesterol (LDL-C), which causes plaques to form in blood vessels.
• Low levels of high-density lipoprotein cholesterol (HDL-C), which helps to remove LDL from the blood.
• High levels of triglycerides, which are stored in fat cells when calories are not burned right away.

Obesity, unhealthy eating and a sedentary lifestyle are the most common causes of dyslipidemia in teens and children. The condition can also be inherited. The most common form of inherited hypercholesterolemia is known as heterozygous familial hypercholesterolemia (FH). Children should be screened for FH when a close relative has high cholesterol or had a heart attack before age 55, if male, and age 65, if female. As many as 1 in 200-250 people are believed to have FH.

Other risk factors for dyslipidemia in children or teens include:

• Hypertension
• Cigarette smoking
• Diabetes (type 1 and type 2)
• Kidney disease
• Hypothyroidism
• Polycystic ovarian syndrome (PCOS)
• Cushing’s syndrome
• Inflammatory bowel disease (IBS)
• HIV infection

Children with dyslipidemia generally do not have symptoms.

Abnormal cholesterol levels are detected through a complete lipid profile using a blood test. It is now recommended that all otherwise healthy children without a family of history of high cholesterol or early coronary artery disease have their cholesterol levels checked once between 9 and 11 years old and again between ages 18 and 21. Children who are at risk of dyslipidemia should be screened as early as age 2 and have their cholesterol levels routinely checked. 

Lifestyle changes are normally always the first steps used to lower high cholesterol in children and teens. Your child’s doctor will recommend moderate to vigorous exercise for at least one hour daily. Dietary changes will include eliminating unhealthy fats and sugar-sweetened beverages and increasing fiber, especially soluble fiber. Eating healthy fats in moderation, such as those found in nuts, avocados, salmon and flaxseed can also control cholesterol.

If cholesterol levels don’t improve with lifestyle changes, your child’s doctor may recommend medications, such as statins, which lower cholesterol by interfering with its production in the liver. Generally, children with familial hypercholesterolemia are started on a statin medication between 8-10 years of age.   

With proper lifestyle and dietary changes, blood lipids should return to normal levels.

Children with genetic dyslipidemia will need lifelong medication and regular follow-up care to manage their blood lipid levels.

The Cardiac Center at Children’s Hospital of Philadelphia (CHOP) offers a Lipid Heart Clinic in six locations for children with dyslipidemia. The Lipid Heart Clinic is part of the Cardiac Center’s Preventive Cardiovascular Program. A team of lipid specialists and dietitians will evaluate and treat your child with a personalized care plan to reduce your child’s risk of early heart disease.