The rationale for lowering serum cholesterol levels in American children

Article Abstract:

Childhood screening for elevated cholesterol levels remains controversial. While the relationship between elevated blood cholesterol levels and the risk of coronary artery disease in adults is clear, there have been no long range studies on the benefits as adults of reducing cholesterol levels as children. Identifying children with high cholesterol levels does not predict coronary artery disease in later life, it predicts high cholesterol later in life. If mass screening were implemented, many children would be falsely labelled as having a high risk for coronary artery disease. Cholesterol screening is also complicated because cholesterol levels vary from day to day. Currently the National Cholesterol Education Program recommends selectively screening children at high risk, such as those whose parents or grandparents had premature heart disease.

Evaluation, Medical screening, Health screening

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Problems with the report of the expert panel on blood cholesterol levels in children and adolescents

Article Abstract:

Efforts to lower blood cholesterol levels in children may be neither cost effective nor sound medical practice. A report published by experts on blood cholesterol levels in children has recommended that children and adolescents should be screened if they have a family history of early cardiovascular disease or high cholesterol. The report recommends that children with high levels of blood cholesterol may be treated with low fat diets and even cholesterol-lowering drugs. In fact, low fat diets may be harmful to children, and may not produce much change in cholesterol levels. Also, cholesterol-lowering drugs may be most beneficial for middle-aged persons with known coronary artery disease rather than beneficial in children. Children with family histories of cardiovascular disease may not necessarily be at high risk themselves.

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Year-to-year variability of cholesterol levels in a pediatric practice

Article Abstract:

Blood cholesterol levels in children may vary significantly by age, by pubertal status, and from year-to-year. A study of 646 children aged three to 19 years in a suburban pediatric practice found that blood cholesterol measurements varied over time, with one third of children tested three times having at least one high cholesterol measurement. Nine to 12 year old children had higher cholesterol levels than children already going through puberty. Just half of preschool children had the same cholesterol classification (low, medium, or high) on two successive visits. The factors most likely to change cholesterol classification were spontaneous day-to-day variability, regression to the average, time between visits, and onset of puberty.

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