High cholesterol screening study
You may have heard about a study of 20,000 West Virginia fifth-graders which concluded that across-the-board screening for high cholesterol levels in children would identify all children with dyslipidemia, or high levels of lipids in the blood. Lipids in the blood can accumulate over time, creating inflammation in the arteries of the heart and the build-up of plaque. The study, published in the journal Pediatrics, suggests universal screening would allow for the proper intervention and follow-up that would help prevent future arterial disease in the children tested.
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Dr. Sarah BlumenscheinThe study also found that some children in the study who didn’t meet the profile for testing for high cholesterol from the federal government’s National Cholesterol Education Program actually did have moderately elevated levels of cholesterol and could benefit from medications or interventions to reduce their cholesterol levels.
What does the study mean for families?
The study substantiates existing data on high cholesterol being more and more prevalent in children and means that it is crucial to the health of your child that you know your family history, says Dr. Sarah Blumenschein, the director of preventive cardiology and a specialist in familial hypercholesterolemia on the medical staff at Children’s Medical Center.
That includes a family history of early heart disease, stroke, high cholesterol, unknown family history and personal risk factors, including diabetes, high blood pressure, obesity/metabolic syndrome, along with other lifestyle factors such as smoking. These can all have a negative impact on your child’s health.
All these family history factors should be raised with your child’s primary care physician, so that your child can be appropriately tested for the risk of heart disease, says Dr. Blumenschein, associate professor of Pediatrics at UT Southwestern Medical Center. And, while pediatricians and pediatric primary care physicians routinely conduct family histories as part of a child’s physical examination, it is up to the family to make sure that their health profile is accurate and up to date.
American Academy of Pediatrics recommendations
In July 2008, the American Academy of Pediatrics (AAP) changed its recommendations concerning the management of high cholesterol levels in children. The change stemmed from evidence that coronary artery disease begins in early childhood and accelerates during adolescence. The current AAP guidelines suggest that all children with family risk factors be screened at the age of 2 years for high cholesterol and then be rescreened every two or three years.
The guidelines also changed from recommending first-line therapy of diet, exercise and supplements alone, such as niacin and other over-the-counter products like fish oil and plant sterol esters. Instead, the AAP began suggesting that children with high cholesterol levels, diabetes and possibly metabolic syndrome/obesity be placed on a category of prescription drugs that is appropriate such as statins at around the age of 8. These drugs have a powerful anti-inflammatory effect in the arteries as well as in reducing bad, or LDL, cholesterol, and so help reduce the risk of future arterial disease.
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