Behind the news - cholesterol screening in children

NEW US guidelines calling for all children to be screened for high cholesterol have reignited debate on the age for pharmaco­logical intervention.

The advice, from the US National Heart, Lung and Blood Institute, recommended children’s lipids be tested once between the ages of nine and 11 years and once between 17 and 21 years. 

The guidelines have been endorsed by the American Academy of Pediatrics (AAP) but met with a mixed reaction.

While lifestyle modification is suggested for the first six months in most patients, the guidelines controversially recommend drug treatment at age 10 for those patients who fail lifestyle changes. The AAP says it is concerned about both genetic and obesity-related CVD risk, but the main goal is to identify familial hyperlipidaemias, found in one in 300–500 children but asymptomatic until myocardial ischaemia.

Australia has no guidelines for testing cholesterol levels in children or