December 29th 2015

Nurse practitioners and physician assistants in retail clinics have their work cut out for them, as one-fifth of children and adolescents need better control over their cholesterol.

Nurse practitioners and physician assistants in retail clinics have their work cut out for them, as one-fifth of children and adolescents need better control over their cholesterol.

Retail clinicians may be the first practitioners to address youth’s cholesterol levels, as aJAMA Pediatricsstudydemonstrated that parents value retail clinics’ convenience and timely care over established relationships with pediatricians.

Since children and adolescents may be more likely to visit a retail clinic regularly, physician assistants and nurse practitioners may be better able to target the 1 in 5 youths who has high total cholesterol, low high-density lipoprotein (HDL) cholesterol, or high non-HDL cholesterol, according to a new US Centers for Disease Control and Prevention (CDC) data brief.

The data brief contained estimates from 2011 to 2014 among youths aged 6 to 19 years. The survey included interviews that took place in patients’ homes and through standardized physical examinations.

Adolescents’ data was more troubling than children’s, as the prevalence of at least one abnormal cholesterol measure increased with age.

Girls had a higher prevalence of high total cholesterol and high non-HDL cholesterol than boys.

In addition, African-American and Asian youth were more likely to have higher total cholesterol than white and Hispanic children and adolescents. However, African-American children and adolescents had the lowest overall prevalence of having at least 1 cholesterol abnormality.

Children and adolescents who are obese face greater cholesterol challenges than those who are a normal weight, as well. In fact, the prevalence of low HDL cholesterol was 5 times greater among obese youth than children and adolescents at a normal weight.

The data also revealed that low HDL was more common (13.4%) than high non-HDL cholesterol (8.4%) or high total cholesterol (7.4%).

The CDC recommended screening children and adolescents for risk factors associated with cardiovascular disease, such as abnormal cholesterol levels.

“Continued monitoring of abnormal cholesterol levels among children and adolescents may inform public health interventions to promote long-term cardiovascular health and prevent cardiovascular disease in adulthood,” the data brief read.

According to the CDC, patients with high total cholesterol have twice the risk for heart disease.

Kristene Diggins, FAANP, DNP, MBA, DCC, CNE, NEA-BC, manager of professional practice for MinuteClinic, previously toldContemporary Clinicthat retail clinicians walk through4 basic stepswhen patients present with high cholesterol.

The following steps can be used to inform both adolescents and their parents about the risks associated with abnormal cholesterol levels:

  1. Educate patients on cholesterol and its link to cardiovascular disease.
  2. Inform them about cholesterol measurement and what their results mean in terms of LDL and HDL levels.
  3. Teach patients about modifiable factors affecting cholesterol levels.
  4. Let them know which factors, in addition to cholesterol, can increase their risk for cardiovascular disease.

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