Panel recommends cholesterol testing for all kids

In June I told you in this blog that “all children should be screened for high cholesterol when they’re 9 to 11 years old according to new guidelines from the National Lipid Association (NLA).” I mentioned then that there would be more guidelines “in the fall. So, stay tuned.” Well now those new recommendations are out:

An expert panels now says that ALL kids should undergo testing for high cholesterol at some point between the ages of 9 and 11, and then again sometime between the ages of 17 and 21.

The Washington Post “The Checkup” blog reports that “the recommendation comes from by a 14-member expert panel convened by the National Heart, Lung and Blood Institute [NHLBI] and endorsed by the American Academy of Pediatrics, which will publish the panel’s report … in the journal Pediatrics.”

This “recommendation marks a significant expansion from the 1992 guidelines, which had recommended that children get their cholesterol checked only if there is a history of high cholesterol or early heart disease in their families.”

The Los Angeles Times reports, “Such guidelines already exist to address heart disease risk in adults, but until now there has been none outlining what works best for children.”

The new “recommendations … are based on studies on all aspects of childhood risk factors for heart disease, carefully graded on the strength of the evidence … said” panel chairman Dr. Stephen R. Daniels, pediatrician-in-chief at Children’s Hospital Colorado.

The AP reports that the physicians “on the expert panel that announced the new guidelines Friday concede there is little proof that testing now will prevent heart attacks decades later. But many doctors say waiting might be too late for children who have hidden risks.”

The NPR “Shots” blog reported, however, that “the new recommendation isn’t universally endorsed. Some doctors think the call for universal screening is overkill, since only about half of children with high cholesterol will go on to have that problem as adults.”

I believe the recommendation for universal screening of children between 9 and 11 years old is reasonable, because the alternative, just targeting the at risk kids for screening (i.e., kids with a family history of high cholesterol) will miss about about half of the kids with high cholesterol inherited from one or both parents (familial hypercholesterolemia).

I already do this with the kids I see and will continue to both do so and recommend other family physicians do the same.

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