Experts divided on cholesterol testing in children

The guidelines from the US National Heart, Lung and Blood Institute (NHLBI) on reducing cardiovascular disease in children and adolescents recommend that all children undergo cholesterol screening once between the ages of 9 and 11 years and once between 17 and 21 years.

The guidelines have been endorsed by the American Academy of Pediatrics (AAP).

The AAP says it is concerned about both genetic and obesity-related CVD risk, but the main goal is to identify familial hyperlipidaemias (FH), found in one in 300–500 children but asymptomatic until myocardial ischaemia.

The lengthy guidelines focus on lifestyle modification for the first six months in most patients. More controversial is the recommendation to consider pharmacologic treatment at age 10 for patients who fail lifestyle changes.

Two of the report’s US authors last week said they disagreed with the advice, as it was hard to justify routine testing when