American Academy of Pediatrics hijacked by Big Pharma

The American Academy of Pediatrics (AAP) is poised to issue recommendations for "wider cholesterol screening for children and more aggressive use ofcholesterol-lowering drugs starting as early as the age of 8 in hopes of preventing adult heart problems."

This is a highly controversial recommendation that smacks of pharmaceuticalcompany influence.

Indeed this recommendation overturns the AAP position-asreported in 2002, by The Washington Post: "The American Academy of Pediatrics (AAP) worries that the FDA's Februaryapproval of Merck's Mevacor (lovastatin) -- for children with a disorderthat gives them very high blood cholesterol -- could fuel more statin use when there is still little long-term safety and efficacy data in children, said John Moore, a pediatric cardiologist at Philadelphia's M.C. Hahnemann Medical Center and chairman of the AAP's cardiology section. There's also no consensus on how best to treat high cholesterol in youngsters, he said."See:http://www.washingtonpost.com/ac2/wp-dyn/A42383-2002May6?language=printer

Neither reporters of the Associated Press or The New York Times questioned what scientific evidence supports the use of statins in children who do nothave heart disease. Cholesterol-lowering drugs were first introduced in 1987 (Mevacor), and are currently the most prescribed drugs in the U.S.

So, why has there been no dramatic improvement in U.S. mortality rates?

Why are more Americans becoming obese, diabetic--and dying of heart attacks compared to the rest of the world? Statins have been proven effective ONLY in patients with a prior history ofheart attacks-not in those deemed to be "at risk" because of high cholesterol.
http://ahrp.blogspot.com/2007/01/are-lipid-lowering-statins-guidelines.html

To gain insight one must turn to physicians who are not on the payroll ofdrug manufacturers. Doctors, such as John Abramson, MD, author of Overdosed America (2004), points out that in clinical trials that included healthy but high-risk people without heart disease, statins were shown to be of no benefit.

For example, for women of any age who do not have heart disease or diabetes, and for men older than 69--who do not have heart disease or diabetes-there was no benefit from ingesting statins. For men aged 30-69 years who are at high risk of developing heart disease statins show a modest benefit: Out of 50 high-risk men taking a statin every day for five years, only one avoids a "cardiac event." In other words, of every 50 men who stay on statins for five years, 49 risk an adverse drug reaction with no benefit. [1]http://www.thelancet.com/journals/lancet/article/PIIS0140673607605194/fulltext

Is it good medicine to expose children to risks of harm in adults are questioned? What is the overall effect on children's health of taking a drug? Warnings and side effects listed on the drugs' label: Lipitor:http://www.fda.gov/cder/foi/label/2007/020702s050lbl.pdf

Given the potential risks of harm from statins-including cognitive impairment, liver damage, and muscle pain, weakness, rigidity, shouldn't we seek alternative ways to reduce the risk of heart disease? Life-style changes, healthy eating, no smoking, and exercise are PROVEN EFFECTIVE against cardiovascular disease-and they pose NO risk of any sort.

Why, then, does the American Academy of Pediatrics recommend a dubious course of treatment with drugs instead?

One clue may be found in list of donors who include McDonald-whose fast-food has contributed mightily to US children's obesity and cholesterolepidemic-and pharmaceutical companies that market statins, such as, AstraZeneca (Crestor), Sanofi-Aventis (Zocor), Merck (Mevacor, Vytorin).http://www.aap.org/donate/fcfhonorroll.htm

Neither the AP nor the Times informed readers about AAP's financial ties to companies with vested interests in the recommendation. The Times quotes Jatinder Bhatia, a member of the academy's nutrition committee who is a professor and chief of neonatology at the Medical Collegeof Georgia in Augusta.

He stated: "We are in an epidemic. The risk of giving statins at a lower age is less than the benefit you're going to get out of it." Times readers are not informed that Dr. Bhtia has extensive pharmaceuticalties as a consultant, speaker, and sits on several company advisory boards-and these may just influence his bald, unsubstantiated statements.

See: http://www.nortonhealthcare.com/pdf/KCH-2045%20Newborn%20Symposium.pdf

Another AAP committee member, Dr. Stephen Daniels, is quoted stating: "the new advice is based on mounting evidence showing that damage leading to heart disease, the nation's leading killer, begins early in life." AP reporter, Lindsey Tanner--but not NYT reporter, Tara Parker Pope -- informed readers that he has worked as a consultant to Abbott Laboratories and Merck& Co.

The 2008 AAP cholesterol recommendations are a crass example of how financial conflicts of interest can influence treatment recommendations by American professional medical associations. Reference: Wright JM and Abramson J. Are lipid-lowering guidelines evidence-based?

THE LANCET Vol 369 January 20, 2007 169.
http://www.thelancet.com/journals/lancet/article/PIIS0140673607605194/fulltext

Written by:
Vera Hassner Sharav
veracare@ahrp.org