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Screening Guidelines Miss Many Kids With High Cholesterol
Date:7/12/2010

the screening criteria. However, in the new study, 71.4 percent of children met the screening criteria.

Going into the study, experts knew that the guidelines might miss some children with elevated cholesterol, but there were concerns about labeling children with a pre-existing condition at such a young age. And there was concern that medications might be overprescribed to children. Also, there were concerns about the cost of universal screening, according to the study.

The CARDIAC Project began in 1998 as a way to identify children who were at risk of developing coronary artery disease through free screenings conducted at school. Since its inception, the study has screened 20,266 fifth-graders from all over West Virginia.

From that group, 71.4 percent met the current screening guidelines, and 8.3 percent (1,204 children) were found to have abnormal fat levels in the blood that included low-density lipoprotein (LDL or the "bad" cholesterol) levels above 130 mg/dL, and 1.2 percent had levels equal to or above 160 mg/dL. When LDL levels reach 160 mg/dL or higher, medication may be considered, Neal said.

Among the remaining 28.6 percent of children who didn't meet screening guidelines, and presumably weren't at high-risk for elevated cholesterol, 9.5 percent had abnormal blood fat levels that included high cholesterol, and 1.7 percent were above the threshold for possible cholesterol-lowering medication use, the study found.

Although West Virginia's population is somewhat heavier than the national average, Neal said he believes these findings would likely be similar in other parts of the country. He said in children, genes play more of a role in cholesterol levels than lifestyle factors do.

Not everyone agrees that all children should have cholesterol screening, however.

"I don't believe in universal screening. I think it should be decided individually -- look at the child and their family history and their lifestyle and
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