November 12, 2011 in Nation/World

Doctors advise kids get cholesterol test

Marilynn Marchione Associated Press
 

Risk factors for children

• By the fourth grade, 10 to 13 percent of U.S. children have high cholesterol, defined as a score of 200 or more.

• Half of children with high cholesterol will also have it as adults, raising the risk of heart disease.

• One-third of U.S. children and teens are obese or overweight, which makes high cholesterol and diabetes more likely.

Among the guidelines

Doctors should:

• Take yearly blood-pressure measurements starting when children are 3.

• Start routine anti-smoking advice when kids are ages 5 to 9, and counsel parents of infants not to smoke in the home.

• Review infants’ family history of obesity and start tracking body mass index, or BMI, a measure of obesity, at age 2.

• Use more frank terms for kids who are overweight and obese.

CHICAGO – Every child should be tested for high cholesterol as early as age 9 – surprising new advice from a government panel that suggests screening kids in grade school for a problem more common in middle age.

The idea will come as a shock to most parents. And it’s certain to stir debate.

The doctors 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.

Fat deposits form in the heart arteries in childhood but don’t usually harden them and cause symptoms until later in life. The panel urges cholesterol screening between ages 9 and 11 – before puberty, when cholesterol temporarily dips – and again between ages 17 and 21.

The panel also suggests diabetes screening every two years starting as early as 9 for children who are overweight and have other risks for Type 2 diabetes, including family history.

The new guidelines are from an expert panel appointed by the National Heart, Lung and Blood Institute and endorsed by the American Academy of Pediatrics.

Until now, cholesterol testing has only been done for kids with a known family history of early heart disease or inherited high cholesterol, or with risk factors such as obesity, diabetes or high blood pressure. That approach misses about 30 percent of kids with high cholesterol.

“If we screen at age 20, it may be already too late,” said one of the guideline panel members, Dr. Elaine Urbina, director of preventive cardiology at Cincinnati Children’s Hospital Medical Center. “To me, it’s not controversial at all. We should have been doing this for years.”

The guidelines say that cholesterol drugs likely would be recommended for less than 1 percent of kids tested, and they shouldn’t be used in children younger than 10 unless they have severe problems.

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