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Do you recommend an exercise routine?
Yes, I recommend that children do the sports and activities that they enjoy with friends and at school. Parents need not discriminate against their children simply because they have FH.
Is treatment the same for boys and girls?
No. I would treat boys more aggressively.
Why are you conservative with prescribing medication to girls?
The occurrence of coronary heart disease in women, even without treatment, is 10 years later than in men. In general, women have less EARLY risk of heart disease than a man with FH. Therefore, treatment in girls can be started when they are older.
Is it safe to prescribe statin medications to girls?
Yes. It is safe to prescribe statin medications to girls, but I would wait until the girl reaches puberty.
Would you automatically start an 18-year-old on medication?
No. It would depend on their cholesterol levels and family history of heart disease.
If a 17-year-old boy has FH, but his cholesterol levels are not extremely high, would you start him on medication?
If he does not have very high cholesterol levels and he does not have a strong family history of heart disease, I would not start him on medication at the age of 17. However, I would follow-up with him to make sure he continues to get his cholesterol levels checked. I always emphasize to all of our children and adolescents with FH, "Whatever you do, don't ever smoke."
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