TUESDAY, July 13 (Health.com) — Cholesterol tests may soon become as routine a part of childhood health care as vaccines. In recent years, a growing number of pediatricians have been pushing for all children to have their cholesterol checked, not just those who appear to be at risk for heart disease later in life.
Supporters of this controversial proposal have some fresh ammunition. A study published on Monday in the journal Pediatrics suggests that testing only children who have a family history of high cholesterol or heart disease, as government guidelines now recommend, misses roughly one-third of kids with high cholesterol.
The study included more than 20,000 fifth graders in West Virginia, 29% of whom did not have red flags due to family history and would not have been screened under government guidelines. Ten percent of those children were found to have high cholesterol, however, and nearly 2% had levels high enough to make them candidates for cholesterol-lowering drugs.
“Our data suggests that if you were to follow the [existing] recommendation, you would miss 36% of children who have significant and quite elevated cholesterol levels,” says William Neal, MD, the senior author of the study and a professor of pediatrics at West Virginia University, in Morgantown.
Levels of bad cholesterol (known as LDL), a primary culprit in heart disease, are considered elevated above 160 mg/dL, “a point where one would at least consider using a cholesterol-lowering medication,” Dr. Neal adds.
The findings have refueled a long-running debate on the appropriate level of cholesterol screening in kids. Some pediatricians, like Dr. Neal, believe that all children should receive cholesterol tests as a matter of course, but others worry that this so-called universal screening won’t have a tangible impact on heart disease rates and could lead to the overuse of statins and other cholesterol-lowering drugs in kids.
Drug companies appear to view children as a growing market for statins. The European Union recently approved a chewable, child-friendly version of the statin Lipitor for use in children 10 years and older. Regular Lipitor has already been approved in the U.S. for the same age group.
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