In “Pathophysiology: The biologic basis for disease in adults and children” by McChance and Huether, the chapter that relates to cardiovascular health is chapter 34 titled “Alterations of Cardiovascular Function in Children.” I think that this chapter is very important to understand compared to the other chapters that are related to cardiovascular health. The reason for this is due to the fact that children are still developing and their bodies require different, more intensive, treatments than adults, whose bodies can handle more damage that comes from therapy. For children, professionals usually recommend therapy before surgery is every seen as a serious treatment. Therapy carries less risk then surgery, and it is also easier to implement in children (McChance & Huether, 2014).
A case study that gives a more in depth look is a 2014 research study that reports on a 10 year initiation of Statin Therapy, an alternative type of therapy, in children suffering from Familial Hypercholesterolemia. The research study was looking to understand the safety and long-term efficacy of statin therapy given to children. There has not been a lot of data for this type of therapy in children, and the research was looking to see its effectiveness and safety for children who have yet to experience puberty. The study took a representative sample of 214 children – aged 8 to 18 – residing in the Netherlands. The research processes – which we won’t go too much into – included a double blind and a placebo effect. The end results showed that there was a statistically significant reduction of carotid intima-media thickness when administering statin treatment compared to the children given the placebo (Kusters et al., 2014).
Now, after 10 years, the researchers implemented an additional test on the recipients of the treatment – placebo or actual – in order get data on the levels of carotid IMT and lipid chains in the test participants. Even after 10 years, the researchers saw that the there were still effects of the treatment lingering, but they concluded that further research would need to be done in order to detect statistical discrepancies and rare events. The main takeaway is that this therapy did indeed work, but statins would need to be initiated at a very early stage in childhood to repair wall morphology and limit the chances of cardiovascular diseases that would happen later in life.
In my opinion, the main takeaway from this experiment is that alternative therapies can, indeed, work, but they are less efficient than the more popularized way of dealing with cardiovascular diseases: surgery. Therapy is good when someone is able to keep administering it and implementing a time table that allows for aggressive therapeutically treatment. However, the researchers even acknowledged that a lot of the recipients had busy lives and could not keep administering this therapy, especially when they grew up and became more busy with their own lives. However, when starting therapy at a young age, good habits may form, and these habits may allow older children to keep administering the therapy.
From my research, a lot of therapies try and make it so that the patient sees an improvement in the morphology of his or her arterial wall. I think that this makes a lot of sense, as most cardiovascular diseases are caused by arteries being clogged. The European Heart Journal published a research article that anti-inflammatory therapies are becoming more popular among people who have a greater risk to have a cardiovascular disease. The journal article also highlights the use of statins in LDL reduction and the reduction of cholesterol. It’s clear that surgery isn’t the only answer to cardiovascular disease, and this is a good thing if one wants to avoid the costs and healing that come from this route (Ridker & Luscher, 2014).
- Kusters, D. M., Avis, H. J., de Groot, E., Wijburg, F. A., Kastelein, J. J., Wiegman, A., & Hutten, B. A. (2014). Ten-year follow-up after initiation of statin therapy in children with familial hypercholesterolemia. Jama, 312(10), 1055-1057.
- McChance, K. L. & Huether, S. E. (2014). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St Louis, MO: Elsevier Mosby.
- Ridker, P. M., & Lüscher, T. F. (2014). Anti-inflammatory therapies for cardiovascular disease. European heart journal, 35(27), 1782-1791.