First, identify whether your child has any of the traditional risk factors for cardiovascular disease: being overweight or obese; having diabetes; having a family history of premature heart disease; or being a smoker.If your child does have one of these risk factors, improve the child's diet and increase physical activity with a goal of weight loss if it is needed.  Lowering your child's cholesterol without a drug is preferable.  For children who have elevated cholesterol but do not have traditional risk factors for heart disease and are otherwise healthy, there is a substantial lack of evidence that treating high cholesterol in this group would reduce the number of heart attacks.  Consumer Reports BBD notes that to date, there are no long-term studies that show whether or not doing so reduces the number of heart attacks or other cardiovascular events as the child becomes an adult.   For children with traditional risk factors for heart disease, such as having diabetes or high blood pressure, smoking, those who are overweight or obese (high BMIs), or those with a family history of early-onset heart disease, cholesterol levels may be more important. But lifestyle changes are particularly crucial for this age group, and they include losing weight if needed, increasing exercise and improving a child's diet for at least two years before considering a drug therapy. A 2009 poll by the Consumer Reports National Research Center suggests that consumers think otherwise.  Only half of consumers are correctly informed about evidence supporting prescription medicines used to treat children.  One third (32%) of Americans are under the false impression that drugs to treat conditions in children have always been proven to be safe and effective in children.

Why Some Women Should Think Twice

Today, 22 percent of Americans 45 or older take statins. There are many women within this group and some may have a low risk for cardiovascular disease (CVD). That is an issue because understanding the benefit statins have for these women has not been clear-cut. Some research has been inconclusive due to the use of significantly fewer women than men in trials. And in some cases, trial results were not initially broken down according to gender. Other analyses have found that statin use did not appear to have a beneficial effect on total mortality for women with or without previous CVD. Consumer Reports BBD offers some considerations to help guide decision-making:  

Women with elevated LDL cholesterol and no other heart disease risk factors can determine their 10-year risk of heart attack by using a free online tool provided by the National Cholesterol Education Panel: hp2010.nhlbihin/atpiii/calculator.aspFor women with already low or very low risk, as determined by the calculator, there are other actions they can take to reduce the risk of heart attack or heart disease, including stopping smoking, losing weight if needed, increasing exercise, eating a "heart-healthy diet," and taking steps to curb stress.Women's cholesterol might naturally rise after menopause. High levels of HDL, or "good" cholesterol, are beneficial.

For women who require a statin:

With all their benefits, statins have downsides that should be considered. Five to 10 percent of users experience mild to severe muscle pain and weakness.   An estimated one percent of people who take statins might develop abnormal liver-function tests.  As with many drugs, we know a lot more about the short-term side effects of statins, like diarrhea and nausea, than the longer-term effects.  That's why statin users should be checked regularly by their doctor.Ask your doctor for the lowest dose possible to achieve your goal of cholesterol reduction.   For most people, a generic statin will be as effective and safe as a branded medicine, and it will cost less.  If you begin to have significant muscle aches after taking a statin, review alternate options with your doctor.The majority of statins can be split in half without any loss of effectiveness.  Good candidates for splitting pills are those statins that cost the same at higher doses, such as Lipitor which costs up to $168 for a monthly supply of 20mg, 40 mg, or 80 mg.  When larger doses cost the same as the smaller dose, you can save money by getting the larger dose and splitting the pills in half.  Consumer Reports BBD recommends talking to your doctor before splitting your statin pills. For a guide to safe and effective pill splitting, go to www.CRBestBuyDrugs.

SOURCE Consumer Reports