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Screening Proposed for Childhood Cholesterol Levels
Date:9/13/2007

e disorder in which someone carries two faulty genes.

"It is the most important known and reversible cause of premature heart attack," Wald said. "It carries a 20- to 39-fold higher risk of dying of a heart attack before age 50."

The test proposed in the report would look for a blood LDL cholesterol level 1.5 times higher than the average for a child in the population being tested. "The first thing we would do then would be to test the parents," Wald said. "One of them would have to be affected, because it is a genetic condition. We could offer the parents immediate treatment."

Treatment for a parent or child carrying the gene would most likely be a cholesterol-lowering statin drug, he said.

A study reported last month by cardiologists at the University of Amsterdam in the Netherlands found that early long-term statin therapy prevented artery damage in children with familial hypercholesterolemia. The study included 214 children who were treated with statins for an average of 4.5 years.

The study participants ranged from 8 to 18 years old. The report described the results as "supporting the concept that statin treatment should be initiated in childhood." The study found "no adverse effects on sexual maturation or growth," the researchers added.

The British researchers "make a very reasonable case for screening" for familial hypercholesterolemia, said Dr. Steven Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic. "I have a cluster of patients I follow, and I know you can give statins to children as young as 13," he added.

But the study alone "is not enough to change our current practice," Nissen said.

"The argument is that their lives would be shortened and the quality of life diminished" without screening, Nissen said. "But a decision about doing this in the United States must involve a lot more thinking and a lot more economic analysis, because it invol
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