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The Rationale for Lowering Serum Cholesterol Levels in American Children

The Rationale for Lowering Serum Cholesterol Levels in American Children Abstract • The pediatric approach to the primary prevention of coronary artery disease in adults remains controversial. Measurement and intervention to lower serum cholesterol levels have been advocated recently in a selected group of American children by the Expert Panel on Blood Cholesterol Levels in Children and Adolescents of the National Cholesterol Education Program. This article reviews the clinical and scientific data contributing to the controversy surrounding cholesterol in American children. Arguments in favor of and opposed to an aggressive approach to identifying American children with elevated serum cholesterol levels are presented. The rationale for a selective screening approach is demonstrated. (AJDC. 1993;147:386-392) References 1. Strong JP, McGill HC Jr. The pediatric aspects of atherosclerosis . J Atheroscler Res . 1969;9:251-265.Crossref 2. Kannel WB, Neaton JD, Wentworth D, et al. Overall and coronary heart mortality rates in relation to major fisk factors in 325,348 men screened for the MRFIT . Am Heart J . 1986;112:825-836.Crossref 3. Frick MH, Elo O, Haapa K, et al. Helsinki Heart Study: primary prevention trial with gemfibrozil in middle-aged men with dyslipidemia . N Engl J Med . 1987;317:1237-1245.Crossref 4. Lipid Research Clinics Program. The Lipid Research Clinics Coronary Primary Prevention Trial results, II: the relationship of reduction of coronary heart disease to cholesterol lowering . JAMA . 1984;251:365-374.Crossref 5. US Public Health Service. The Health Consequences of Smoking: Cardio-vascular Disease: A Report of the Surgeon General . Washington, DC: Dept of Health and Human Services; 1983. Dept of Health and Human Services Publication 84-50204. 6. Blankenhorn DH, Nessim SA, Johnson RL, Sanmarco ME, Azen SP, Cashin-Hemphill L. Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass grafts . JAMA . 1987;257:3233-3240.Crossref 7. Brown C, Albers JJ, Fisher LD, et al. Regression of coronary artery disease as a result of intensive lipid-lowering therapy in men with high levels of apolipoprotein B . N Engl J Med . 1990;323:1289-1298.Crossref 8. Lowering blood cholesterol to prevent heart disease . JAMA . 1985;253: 2080-2086. Consensus Conference.Crossref 9. National Cholesterol Education Program. Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents . Pediatrics . 1992;89: 525-584. 10. Stamler J, Wentworth D, Neaton JD, for the MRFIT Research Group. Is the relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? findings in 356 222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT) . JAMA . 1986;256:2823-2828.Crossref 11. Kannel WB, McGee D, Gordon T. A general cardiovascular risk profile: the Framingham Study . Am J Cardiol . 1976;38:46-51.Crossref 12. Kwiterovich PO. Clinical epidemiologic, genetic, and pathologic data in the pediatric age group relevant to the cholesterol hypothesis . Pediatrics . 1986;78:349-362. 13. Newman WP, Freedman DJ, Voors AW, et al. Relation of serum lipoprotein levels and systolic blood pressure to early atherosclerosis: the Bogalusa Heart Study . N Engl J Med . 1986;314:138-144.Crossref 14. PDAY Research Group. Relationship of atherosclerosis in young men to serum lipoprotein cholesterol concentrations and smoking: a preliminary report from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group . JAMA . 1990;264:3018-3024.Crossref 15. Brown MS, Goldstein JL. A receptor-mediated pathway for cholesterol homeostasis . Science . 1986;232:34-47.Crossref 16. Fredrickson DS, Goldstein JL, Brown MS. The familial hyperlipoproteinemias . In: Stanbury JB, Wyngaarden JB, Fredrickson DS, eds. The Metabolic Basis of Inherited Disease . 4th ed. New York, NY: McGraw-Hill International Book Co; 1978:604-655. 17. Webber LS, Srinivasan SR, Wattigney WA, Berenson GS. Tracking of serum lipids and lipoproteins from childhood to adulthood: the Bogalusa Heart Study . Am J Epidemiol . 1991;133:884-899. 18. Stuhldreher WL, Orchard TJ, Donahue RP, Kuller LG, Gloninger MF, Drash AL. Cholesterol screening in childhood: sixteen-year Beaver County Lipid Study experience . J Pediatr . 1991;119:551-556.Crossref 19. Lauer RM, Lee J, Clarke WR. Factors affecting the relationship between childhood and adult cholesterol levels: the Muscatine Study . Pediatrics . 1988;82:309-318. 20. Lauer RM, Clarke WR. Use of cholesterol measurements in childhood for the prediction of adult hypercholesterolemia . JAMA . 1990;264:3034-3038.Crossref 21. Newman TB, Browner WS, Hulley SB. The case against childhood cholesterol screening . JAMA . 1990;264:3039-3043.Crossref 22. Canner PL, Berge KG, Wenger NK, et al. Fifteen-year mortality in Coronary Drug Project patients: long-term benefit with niacin . J Am Coll Cardiol . 1986;8:1245-1255.Crossref 23. Holme I. An analysis of randomized trials evaluating the effect of cholesterol reduction on total mortality and coronary heart disease incidence . Circulation . 1990;82:1916-1924.Crossref 24. Committee of Principal Investigators. A co-operative trial in the primary prevention of ischemic heart disease using clofibrate . Br Heart J . 1978;40:1069-1118.Crossref 25. Buchwald H, Varco RL, Matts JP, et al. Effect of partial ileal bypass surgery on mortality and morbidity from coronary heart disease in patients with hypercholesterolemia: report of the Program on the Surgical Control of the Hyperlipidemias (POSCH) . N Engl J Med . 1990;323:946-955.Crossref 26. Kwiterovich PO Jr, Fredrickson DS, Levy RI. Familial hypercholesterolemia (one form of familial type II hyperlipoproteinemia): a study of its biochemical, genetic, and clinical presentation in childhood . J Clin Invest . 1974;53:1237-1247.Crossref 27. Resnicow K, Morley-Kotchen J, Wynder EL. Plasma cholesterol levels of 6585 children in the United States: results of the Know Your Body screening in five states . Pediatrics . 1989;84:969-976. 28. Tamir I, Heiss G,Glueck CJ,Christensen B, Kwiterovich P, Rifkind BM. Lipid and lipoprotein distributions in white children ages 6-19 yr: the Lipid Research Clinics Program Prevalence Study . J Chronic Dis . 1981;34:27-39.Crossref 29. Gidding S, Liu K, Bild D, Wagenknecht L, Flack J, Hulley S. Use of life-style factors to identify young adults with low LDL cholesterol: the CARDIA Study . Circulation . 1991;83:732. 30. Dennison BA, Kikuchi DA, Srinivasan SR, Webber LS, Berenson GS. Serum total cholesterol screening for the detection of elevated low-density lipoprotein in children and adolescents: the Bogalusa Heart Study . Pediatrics . 1990;85:472-479. 31. National Cholesterol Education Program. Recommendations for Improving Cholesterol Measurement . Bethesda, Md: US Dept of Health and Human Services, Public Health Service, National Institutes of Health, National Heart, Lung and Blood Institute; (February) 1990. NIH publication 90-2964. 32. Bookstein L, Gidding SS, Donovan M, Smith FA. Day-to-day variability of serum cholesterol, triglyceride, and high-density lipoprotein cholesterol levels: impact on the assessment of risk according to the National Cholesterol Education Program guidelines . Arch Intern Med . 1990;150:1653-1657.Crossref 33. Jacobs DR Jr, Barrett-Connor E. Retest reliability of plasma cholesterol and triglyceride: the Lipid Research Clinics Prevalence Study . Am J Epidemiol . 1982;116:878. 34. Hegsted DM, Nicolosi RJ. Individual variation in serum cholesterol levels . Proc Natl Acad Sci U S A . 1987;84:6259-6261.Crossref 35. Demacker PNM, Schade RWB, Jansen RTP, Van'tlaar A. Intraindividual variation of serum cholesterol, triglycerides, and high density lipoprotein cholesterol in normal humans . Atherosclerosis . 1982;45:259-266.Crossref 36. Resnicow K, Berenson G, Shea S, Srinivasan S, Strong W, Wynder EL. The case against 'the case against childhood cholesterol screening.' JAMA . 1991;265:3003-3005.Crossref 37. American Academy of Pediatrics Committee on Nutrition. Prudent lifestyle for children: dietary fat and cholesterol . Pediatrics . 1986;78:521-525. 38. Newman TB, Browner WS, Hulley SB. Childhood cholesterol screening: contraindicated . JAMA . 1992;267:100-101.Crossref 39. Mauer AM. A pediatrician attends the National Institutes of Health Consensus Conference on Lowering Blood Cholesterol . Pediatrics . 1985;76: 125-126. 40. Dennison BA, Kikuchi DA, Srinivasan SR, Webber LS, Berenson GS. Parental history of cardiovascular disease as an indication for screening for lipoprotein abnormalities in children . J Pediatr . 1989;115:186-194.Crossref 41. Griffin TC, Christoffel KK, Binns HG, McGuire PA, Pediatric Practice Research Group. Family history evaluation as a predictive screen for childhood hypercholesterolemia . Pediatrics . 1989;84:365-373. 42. Lee J, Lauer RM, Clarke WR. Lipoproteins in the progeny of young men with coronary artery disease: children with increased risk . Pediatrics . 1986; 78:330-337. 43. Benuck I, Gidding SS, Donovan M, Traisman ES, Traisman HS. Usefulness of parental total cholesterol levels in identifying children with hypercholesterolemia . Am J Cardiol . 1992;69:713-717.Crossref 44. Gidding SS, Whiteside P, Weaver S, Bookstein L, Rosenbaum D, Christoffel K. The child as proband: high prevalence of unrecognized and untreated hyperlipidemia in parents of hyperlipidemic children . Clin Pediatr . 1989;28:462-465.Crossref 45. Strong WB, Deckelbaum RJ, Gidding SS, et al. Integrated cardiovascular health promotion in childhood: a statement for health professionals from the Subcommittee on Atherosclerosis and Hypertension in Childhood of the Council on Cardiovascular Disease in the Young, American Heart Association . Circulation . 1992;58:1638-1650.Crossref 46. Pahl E, Fricker FJ, Armitage J, et al. Coronary arteriosclerosis in pediatric heart transplant survivors: limitation of long-term survival . J Pediatr . 1990;116:177-183.Crossref 47. Nanton MA, Olley PM. Residual hypertension after coarctectomy in children . Am J Cardiol . 1976;37:769-772.Crossref 48. Anderson S, Garcia DL, Brenner BM. Renal and systemic manifestations of glomerular disease . In: Brenner BM, Rector FC, eds. The Kidney . Philadelphia, Pa: WB Saunders Co; 1991:1931. 49. Kato H, Ichinose E, Takechi T, Yoshioka F, Suzuki K, Rikitake N. Fate of coronary aneurysms in Kawasaki disease: serial coronary angiography and long-term follow-up . Am J Cardiol . 1982;49:1758-1766.Crossref 50. Grundy SM, Goodman DS, Rifkind BM, Cleeman JI. The place of HDL in cholesterol management: a perspective from the National Cholesterol Education Program . Arch Intern Med . 1989;149:505-510.Crossref 51. Kwiterovich PO Jr. HyperapoB: a pleiotrophic phenotype characterized by dense low-density lipoproteins and associated with coronary artery disease . Clin Chem . 1988;34:B71-B77. 52. Srinivasan SR, Dahlen GH, Jarpa RA, Webber LS, Berenson GS. Racial (black-white) differences in serum lipoprotein (a) distribution and its relation to parental myocardial infarction in children: the Bogalusa Heart Study . Circulation . 1991;84:160-167.Crossref 53. Kuller LG, Traven ND, Rutan GH, Perper JA, Ives DG. Marked decline of coronary heart disease mortalityin 35-44-year-old white men in Allegheny County, Pennsylvania . Circulation . 1989;80:261-266.Crossref 54. Sempos C, Cooper R, Kovar MG, McMillen M. Divergence of the recent trends in coronary mortality for the four major race-sex groups in the United States . Am J Public Health . 1988;78:1422-1427.Crossref 55. Kaplan RM, Toshima MT. Does a reduced fat diet cause retardation in child growth? Prev Med . 1992;21:33-52.Crossref 56. Lifshitz F, Moses N. Growth failure: a complication of dietary treatment of hypercholesterolemia . AJDC . 1989;143:537-542. 57. Pugliese MY, Weyman-Daum M, Moses N, Lifshitz F. Parental health beliefs as a cause of nonorganic failure to thrive . Pediatrics . 1987;80:175-182. 58. McPherson RS, Nichajan MZ, Kohl HW, Reed DB, Labarthe DR. Intake and food sources of dietary fat among schoolchildren in The Woodlands, Texas . Pediatrics . 1990;86:520-526. 59. Nicklas TA, Weber LS, Koschak M, Berenson GS. Nutrient adequacy of low fat intakes for children: the Bogalusa Heart Study . Pediatrics . 1992;89:221-228. 60. West RJ, Lloyd JK, Leonard JV. Long-term follow-up of children with familial hypercholesterolemia treated with cholestyramine . Lancet . 1980;2: 873-875.Crossref 61. Muldoon MF, Manuck SB, Matthews KA. Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials . BMJ . 1990;301:309-314.Crossref 62. Thelin T, McNeil E, Aspegren-Hansson E, Sveger T. Identifying children at high somatic risk: possible long-term effects on the parents' view of their own health and current life situation . Acta Psychiatr Scand . 1985;71: 653-664. 63. Smith GD, Pekkanen J. Should there be a moratorium on the use of cholesterol lowering drugs? BMJ . 1992;304:431-434.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

The Rationale for Lowering Serum Cholesterol Levels in American Children

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1993.02160280036014
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Abstract

Abstract • The pediatric approach to the primary prevention of coronary artery disease in adults remains controversial. Measurement and intervention to lower serum cholesterol levels have been advocated recently in a selected group of American children by the Expert Panel on Blood Cholesterol Levels in Children and Adolescents of the National Cholesterol Education Program. This article reviews the clinical and scientific data contributing to the controversy surrounding cholesterol in American children. Arguments in favor of and opposed to an aggressive approach to identifying American children with elevated serum cholesterol levels are presented. The rationale for a selective screening approach is demonstrated. (AJDC. 1993;147:386-392) References 1. Strong JP, McGill HC Jr. The pediatric aspects of atherosclerosis . J Atheroscler Res . 1969;9:251-265.Crossref 2. Kannel WB, Neaton JD, Wentworth D, et al. Overall and coronary heart mortality rates in relation to major fisk factors in 325,348 men screened for the MRFIT . Am Heart J . 1986;112:825-836.Crossref 3. Frick MH, Elo O, Haapa K, et al. Helsinki Heart Study: primary prevention trial with gemfibrozil in middle-aged men with dyslipidemia . N Engl J Med . 1987;317:1237-1245.Crossref 4. Lipid Research Clinics Program. The Lipid Research Clinics Coronary Primary Prevention Trial results, II: the relationship of reduction of coronary heart disease to cholesterol lowering . JAMA . 1984;251:365-374.Crossref 5. US Public Health Service. The Health Consequences of Smoking: Cardio-vascular Disease: A Report of the Surgeon General . Washington, DC: Dept of Health and Human Services; 1983. Dept of Health and Human Services Publication 84-50204. 6. Blankenhorn DH, Nessim SA, Johnson RL, Sanmarco ME, Azen SP, Cashin-Hemphill L. Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass grafts . JAMA . 1987;257:3233-3240.Crossref 7. Brown C, Albers JJ, Fisher LD, et al. Regression of coronary artery disease as a result of intensive lipid-lowering therapy in men with high levels of apolipoprotein B . N Engl J Med . 1990;323:1289-1298.Crossref 8. Lowering blood cholesterol to prevent heart disease . JAMA . 1985;253: 2080-2086. Consensus Conference.Crossref 9. National Cholesterol Education Program. Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents . Pediatrics . 1992;89: 525-584. 10. Stamler J, Wentworth D, Neaton JD, for the MRFIT Research Group. Is the relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? findings in 356 222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT) . JAMA . 1986;256:2823-2828.Crossref 11. Kannel WB, McGee D, Gordon T. A general cardiovascular risk profile: the Framingham Study . Am J Cardiol . 1976;38:46-51.Crossref 12. Kwiterovich PO. Clinical epidemiologic, genetic, and pathologic data in the pediatric age group relevant to the cholesterol hypothesis . Pediatrics . 1986;78:349-362. 13. Newman WP, Freedman DJ, Voors AW, et al. Relation of serum lipoprotein levels and systolic blood pressure to early atherosclerosis: the Bogalusa Heart Study . N Engl J Med . 1986;314:138-144.Crossref 14. PDAY Research Group. Relationship of atherosclerosis in young men to serum lipoprotein cholesterol concentrations and smoking: a preliminary report from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group . JAMA . 1990;264:3018-3024.Crossref 15. Brown MS, Goldstein JL. A receptor-mediated pathway for cholesterol homeostasis . Science . 1986;232:34-47.Crossref 16. Fredrickson DS, Goldstein JL, Brown MS. The familial hyperlipoproteinemias . In: Stanbury JB, Wyngaarden JB, Fredrickson DS, eds. The Metabolic Basis of Inherited Disease . 4th ed. New York, NY: McGraw-Hill International Book Co; 1978:604-655. 17. Webber LS, Srinivasan SR, Wattigney WA, Berenson GS. Tracking of serum lipids and lipoproteins from childhood to adulthood: the Bogalusa Heart Study . Am J Epidemiol . 1991;133:884-899. 18. Stuhldreher WL, Orchard TJ, Donahue RP, Kuller LG, Gloninger MF, Drash AL. Cholesterol screening in childhood: sixteen-year Beaver County Lipid Study experience . J Pediatr . 1991;119:551-556.Crossref 19. Lauer RM, Lee J, Clarke WR. Factors affecting the relationship between childhood and adult cholesterol levels: the Muscatine Study . Pediatrics . 1988;82:309-318. 20. Lauer RM, Clarke WR. Use of cholesterol measurements in childhood for the prediction of adult hypercholesterolemia . JAMA . 1990;264:3034-3038.Crossref 21. Newman TB, Browner WS, Hulley SB. The case against childhood cholesterol screening . JAMA . 1990;264:3039-3043.Crossref 22. Canner PL, Berge KG, Wenger NK, et al. Fifteen-year mortality in Coronary Drug Project patients: long-term benefit with niacin . J Am Coll Cardiol . 1986;8:1245-1255.Crossref 23. Holme I. An analysis of randomized trials evaluating the effect of cholesterol reduction on total mortality and coronary heart disease incidence . Circulation . 1990;82:1916-1924.Crossref 24. Committee of Principal Investigators. A co-operative trial in the primary prevention of ischemic heart disease using clofibrate . Br Heart J . 1978;40:1069-1118.Crossref 25. Buchwald H, Varco RL, Matts JP, et al. Effect of partial ileal bypass surgery on mortality and morbidity from coronary heart disease in patients with hypercholesterolemia: report of the Program on the Surgical Control of the Hyperlipidemias (POSCH) . N Engl J Med . 1990;323:946-955.Crossref 26. Kwiterovich PO Jr, Fredrickson DS, Levy RI. Familial hypercholesterolemia (one form of familial type II hyperlipoproteinemia): a study of its biochemical, genetic, and clinical presentation in childhood . J Clin Invest . 1974;53:1237-1247.Crossref 27. Resnicow K, Morley-Kotchen J, Wynder EL. Plasma cholesterol levels of 6585 children in the United States: results of the Know Your Body screening in five states . Pediatrics . 1989;84:969-976. 28. Tamir I, Heiss G,Glueck CJ,Christensen B, Kwiterovich P, Rifkind BM. Lipid and lipoprotein distributions in white children ages 6-19 yr: the Lipid Research Clinics Program Prevalence Study . J Chronic Dis . 1981;34:27-39.Crossref 29. Gidding S, Liu K, Bild D, Wagenknecht L, Flack J, Hulley S. Use of life-style factors to identify young adults with low LDL cholesterol: the CARDIA Study . Circulation . 1991;83:732. 30. Dennison BA, Kikuchi DA, Srinivasan SR, Webber LS, Berenson GS. Serum total cholesterol screening for the detection of elevated low-density lipoprotein in children and adolescents: the Bogalusa Heart Study . Pediatrics . 1990;85:472-479. 31. National Cholesterol Education Program. Recommendations for Improving Cholesterol Measurement . Bethesda, Md: US Dept of Health and Human Services, Public Health Service, National Institutes of Health, National Heart, Lung and Blood Institute; (February) 1990. NIH publication 90-2964. 32. Bookstein L, Gidding SS, Donovan M, Smith FA. Day-to-day variability of serum cholesterol, triglyceride, and high-density lipoprotein cholesterol levels: impact on the assessment of risk according to the National Cholesterol Education Program guidelines . Arch Intern Med . 1990;150:1653-1657.Crossref 33. Jacobs DR Jr, Barrett-Connor E. Retest reliability of plasma cholesterol and triglyceride: the Lipid Research Clinics Prevalence Study . Am J Epidemiol . 1982;116:878. 34. Hegsted DM, Nicolosi RJ. Individual variation in serum cholesterol levels . Proc Natl Acad Sci U S A . 1987;84:6259-6261.Crossref 35. Demacker PNM, Schade RWB, Jansen RTP, Van'tlaar A. Intraindividual variation of serum cholesterol, triglycerides, and high density lipoprotein cholesterol in normal humans . Atherosclerosis . 1982;45:259-266.Crossref 36. Resnicow K, Berenson G, Shea S, Srinivasan S, Strong W, Wynder EL. The case against 'the case against childhood cholesterol screening.' JAMA . 1991;265:3003-3005.Crossref 37. American Academy of Pediatrics Committee on Nutrition. Prudent lifestyle for children: dietary fat and cholesterol . Pediatrics . 1986;78:521-525. 38. Newman TB, Browner WS, Hulley SB. Childhood cholesterol screening: contraindicated . JAMA . 1992;267:100-101.Crossref 39. Mauer AM. A pediatrician attends the National Institutes of Health Consensus Conference on Lowering Blood Cholesterol . Pediatrics . 1985;76: 125-126. 40. Dennison BA, Kikuchi DA, Srinivasan SR, Webber LS, Berenson GS. Parental history of cardiovascular disease as an indication for screening for lipoprotein abnormalities in children . J Pediatr . 1989;115:186-194.Crossref 41. Griffin TC, Christoffel KK, Binns HG, McGuire PA, Pediatric Practice Research Group. Family history evaluation as a predictive screen for childhood hypercholesterolemia . Pediatrics . 1989;84:365-373. 42. Lee J, Lauer RM, Clarke WR. Lipoproteins in the progeny of young men with coronary artery disease: children with increased risk . Pediatrics . 1986; 78:330-337. 43. Benuck I, Gidding SS, Donovan M, Traisman ES, Traisman HS. Usefulness of parental total cholesterol levels in identifying children with hypercholesterolemia . Am J Cardiol . 1992;69:713-717.Crossref 44. Gidding SS, Whiteside P, Weaver S, Bookstein L, Rosenbaum D, Christoffel K. The child as proband: high prevalence of unrecognized and untreated hyperlipidemia in parents of hyperlipidemic children . Clin Pediatr . 1989;28:462-465.Crossref 45. Strong WB, Deckelbaum RJ, Gidding SS, et al. Integrated cardiovascular health promotion in childhood: a statement for health professionals from the Subcommittee on Atherosclerosis and Hypertension in Childhood of the Council on Cardiovascular Disease in the Young, American Heart Association . Circulation . 1992;58:1638-1650.Crossref 46. Pahl E, Fricker FJ, Armitage J, et al. Coronary arteriosclerosis in pediatric heart transplant survivors: limitation of long-term survival . J Pediatr . 1990;116:177-183.Crossref 47. Nanton MA, Olley PM. Residual hypertension after coarctectomy in children . Am J Cardiol . 1976;37:769-772.Crossref 48. Anderson S, Garcia DL, Brenner BM. Renal and systemic manifestations of glomerular disease . In: Brenner BM, Rector FC, eds. The Kidney . Philadelphia, Pa: WB Saunders Co; 1991:1931. 49. Kato H, Ichinose E, Takechi T, Yoshioka F, Suzuki K, Rikitake N. Fate of coronary aneurysms in Kawasaki disease: serial coronary angiography and long-term follow-up . Am J Cardiol . 1982;49:1758-1766.Crossref 50. Grundy SM, Goodman DS, Rifkind BM, Cleeman JI. The place of HDL in cholesterol management: a perspective from the National Cholesterol Education Program . Arch Intern Med . 1989;149:505-510.Crossref 51. Kwiterovich PO Jr. HyperapoB: a pleiotrophic phenotype characterized by dense low-density lipoproteins and associated with coronary artery disease . Clin Chem . 1988;34:B71-B77. 52. Srinivasan SR, Dahlen GH, Jarpa RA, Webber LS, Berenson GS. Racial (black-white) differences in serum lipoprotein (a) distribution and its relation to parental myocardial infarction in children: the Bogalusa Heart Study . Circulation . 1991;84:160-167.Crossref 53. Kuller LG, Traven ND, Rutan GH, Perper JA, Ives DG. Marked decline of coronary heart disease mortalityin 35-44-year-old white men in Allegheny County, Pennsylvania . Circulation . 1989;80:261-266.Crossref 54. Sempos C, Cooper R, Kovar MG, McMillen M. Divergence of the recent trends in coronary mortality for the four major race-sex groups in the United States . Am J Public Health . 1988;78:1422-1427.Crossref 55. Kaplan RM, Toshima MT. Does a reduced fat diet cause retardation in child growth? Prev Med . 1992;21:33-52.Crossref 56. Lifshitz F, Moses N. Growth failure: a complication of dietary treatment of hypercholesterolemia . AJDC . 1989;143:537-542. 57. Pugliese MY, Weyman-Daum M, Moses N, Lifshitz F. Parental health beliefs as a cause of nonorganic failure to thrive . Pediatrics . 1987;80:175-182. 58. McPherson RS, Nichajan MZ, Kohl HW, Reed DB, Labarthe DR. Intake and food sources of dietary fat among schoolchildren in The Woodlands, Texas . Pediatrics . 1990;86:520-526. 59. Nicklas TA, Weber LS, Koschak M, Berenson GS. Nutrient adequacy of low fat intakes for children: the Bogalusa Heart Study . Pediatrics . 1992;89:221-228. 60. West RJ, Lloyd JK, Leonard JV. Long-term follow-up of children with familial hypercholesterolemia treated with cholestyramine . Lancet . 1980;2: 873-875.Crossref 61. Muldoon MF, Manuck SB, Matthews KA. Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials . BMJ . 1990;301:309-314.Crossref 62. Thelin T, McNeil E, Aspegren-Hansson E, Sveger T. Identifying children at high somatic risk: possible long-term effects on the parents' view of their own health and current life situation . Acta Psychiatr Scand . 1985;71: 653-664. 63. Smith GD, Pekkanen J. Should there be a moratorium on the use of cholesterol lowering drugs? BMJ . 1992;304:431-434.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Apr 1, 1993

References