Q. Do children need their cholesterol checked?
A. The National Heart, Lung and Blood Institute issued guidelines in 2011 recommending that children ages 9 to 11 get a cholesterol test, and the American Academy of Pediatrics supports screening. But the recommendation has been controversial, with some experts arguing that testing could lead to children taking cholesterol-lowering medications unnecessarily.
Stephen Daniels, chairman of pediatrics at the University of Colorado School of Medicine, chaired the panel that made the guidelines and says the goal of testing is to better identify children who have familial hyperlipidemia, an inherited condition that carries a 20-times greater risk of early heart disease. Physicians have long tested children’s cholesterol if there is a family history of high cholesterol and heart disease. But because family history isn’t always well documented and tracked, “a better way of identifying more children who fall in this category would be to do universal screening,” he says. Because cholesterol levels drop in puberty, levels at age 9 to 11 are more predictive of adult risk.
Daniels says that children who are obese or sedentary don’t typically have the extremely high cholesterol levels designed to be identified by these guidelines. But research shows that cardiovascular disease can have its root in childhood health habits, and universal cholesterol screening is expected to prompt discussion about lifestyle interventions and treatment for other children who might be on track for health problems. Daniels says parents should know their family health history to guide their decision about testing.