Family history and genetics also play a role, especially for children who have high cholesterol despite maintaining a normal weight.
These risk factors have led to new cholesterol screening guidelines for all children, first between ages 9-11 and again at 17-21. The recommendations come from the National Heart, Lung and Blood Institute and are endorsed by the American Academy of Pediatrics.
“The previous guidelines recommended children who were at least 2 years old with risk factors such as obesity, diabetes, high blood pressure or a known family history of coronary artery disease be screened for high cholesterol,” said Dr. Peter Vande Kappelle, a pediatric cardiologist and director of preventive cardiology at Akron Children’s Hospital.
The new guidelines will help identify the estimated 12 percent of healthy weight kids who have some cholesterol abnormality, but are otherwise symptom-free. Dr. Vande Kappelle expects that 1 percent will have extremely high cholesterol that requires medication.
“High cholesterol is the most common genetic abnormality, so we know we are missing a lot of kids without universal screening,” he said. “It’s also symptom-free, until it leads to a premature heart attack or stroke in adulthood.”
The goal of universal screening is two-fold.
One is to identify children who have a genetic predisposition for high cholesterol, which puts them at risk for a premature heart attack or stroke.
The second is to help those with borderline high cholesterol adopt healthy changes in diet and exercise. Healthy habits formed in childhood are more likely to become part of an individual’s lifestyle as an adult.
Universal screening is not intended to put all children on medication, although those with extremely high cholesterol, typically due to a genetic disorder, will likely need medication to lower their cholesterol.