Children Not Adequately Addressed in Cholesterol Guidelines

A recent study published in Pediatrics suggests that current guidelines for screening high cholesterol in kids are not sufficient enough. In fact, this study found that 9.5% of children who would not normally be monitored under the current guidelnes had high cholesterol levels. Of those children, almost 2% had cholesterol levels high enough to require cholesterol-lowering medications.

This study screened over 20,000 fifth-grade children in West Virginia. Roughly 70% of the children screened for high cholesterol had a family history of it. Per the currently guidelines, children are only screened if they have a family history of premature heart disease, one parent has a total cholesterol level that exceeds 240 mg/dL, or their family history is unknown. Of those children who had a family history of some form of early heart disease or high cholesterol, 8% also had elevated cholesterol levels.

This study illustrates the necessity of modifying these guidelines. Children who didn't need to be screened for high cholesterol under the current guidelines would have been missed -- resulting in continued high cholesterol levels that could result in future complications. It also suggests that high cholesterol, a condition that we only think occurs in adults, is also increasingly being noted in children. While the majority of this may be due to lifestyle (lack of exercise, diet, obesity, etc), broadening the current guidelines for screening in children would help us to prevent heart disease down the road, and instill positive lifestyle changes early in life.

_{Ritchie SK, Murphy ESC, Ice C, et al. Universal versus targeted blood cholesterol screening among youth: the CARDIAC project. Pediatrics 2010:126:260-265.}