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Panel recommends children get tested for cholesterol by age 11

November 11, 2011 12:00:00 AM PST
Should kids be tested for cholesterol? And how young is too young?

A panel of doctors is recommending that every child be tested for high cholesterol between ages 9 and 11 to prevent heart disease later in life. It's a decision that's bound to be controversial, as some parents wonder if some children will be put on medication.

While high cholesterol isn't common in kids, doctors say there are risk factors in childhood, like obesity, that can show up later on in adulthood as serious heart disease. So pediatricians now say one way of attacking the problem before it starts is to keep track of cholesterol.

Heart disease runs on both sides of 13-year-old Ellie Bonaie's family. So she's getting her cholesterol checked. It seems unusual because she's so young, but with these new guidelines, cholesterol testing in children will soon become routine.

Doctors recommend screening between ages 9 and 11 because cholesterol dips during puberty and rises later. They also advise testing again later, between ages 17 and 21.

The American Academy of Pediatrics supports these new guidelines.

Studies show adult heart disease really begins in childhood. The goal is to accurately identify kids at high risk and head it off before these kids get heart attacks and strokes later in life.

"If you have objective evidence that your child is at risk for heart disease you may be more likely to enforce healthier activity, physical activity and diet," said Dr. Steven Mittelman, a pediatric endocrinologist.

While screening 9 to 11 year olds for high cholesterol could encourage better eating and more exercise, some experts are concerned that it could lead to more kids being put on cholesterol lowering medications.

Dr. Mittelman says less than 1 percent of children, primarily those with genetic high cholesterol, would qualify for cholesterol-lowering medications, like statins. Most children found to have high cholesterol would be advised to control it with diet and physical activity.

And children younger than 10 should not be treated with cholesterol drugs unless they have severe cholesterol problems, the guidelines say.

The new recommendation also targets age-specific strategies to reduce risk factors in kids, like weight. But experts are divided on whether universal testing in children will be cost efficient.

"I think we have to be cautious. I think we're going to be getting a lot of blood tests and that's going to cost a lot of money, and it remains to be seen how many kids we are actually going to be able to help at this point," said Dr. Mittelman.

Ellie's test results revealed she needs to make some lifestyle changes, but she's glad she's being told early.

"I'm going to take in more physical activities like sports and control my diet," she said.

The panel also recommends 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 guidelines also say doctors should:

  • Take yearly blood pressure measurements for children starting at age 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.

The new guidelines come from an expert panel appointed by the National Heart, Lung and Blood Institute. Several doctors on the panel have received consulting fees or have had other financial ties to cholesterol drug manufacturers.

The Associated Press contributed to this report.

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