A person’s first cholesterol test should take place when he/she is 15 months old, according to an article in the British Medical Journal (BMJ). The authors explain that familial hypercholesterolemia, high LDL cholesterol levels that runs in families, carries a significant risk of death from coronary heart disease.

Approximately 2 out of every 1,000 people have familial hypercholesterolemia. There are treatments available today which can decrease the risk of death from coronary heart disease for such people.

Scientists at Barts and the London Queen Mary’s School of Medicine and Dentistry, UK, examined 13 prior studies which focused on total and LDL cholesterol in people with and without familial hypercholesterolemia, involving 1,907 cases and 16,221 controls. They wanted to find out how effective screening might be, and if so, at what age.

For screening to be most effective, the authors wrote, it needs to be done when a child is aged between 1 and 9 years. At this age screening detects 88% of individuals with familial hypercholesterolemia. The researchers found that the screening of young adults or newborns was far less effective.

When children are about 15 months old, about the time the go in for their routine vaccinations, they should be screened, say the writers. On being identified as having familial hypercholesterolemia, the child’s parents could also be screened, given that it is an inherited disorder the chances are that one parent is also affected. The affected parent could then receive cholesterol lowering treatment immediately, while the child would be penciled in for treatment later on in life.

Another advantage of screening children during their first bout of immunizations, say the authors, is that parents are more interested, at this point, in the possibility of preventing disease in their kid. It would be logical to suppose that the parent himself/herself would also be keener on a family-based strategy.

This strategy kills two birds with one stone. It identifies both children and parent(s) simultaneously, and would protect the majority of people with familial hypercholesterolemia from premature coronary heart disease, they say.

“Child-parent screening for familial hypercholesterolemia: screening strategy based on meta-analysis”
David S Wald, Jonathan P Bestwick, Nicholas J Wald
doi:10.1136/bmj.39300.616076.55
http://www.bmj.com

Written by: Christian Nordqvist