Cardiovascular disease is the leading cause of death in adults in America. Research has shown that the damage to the heart and blood vessels often beings in childhood. In order to prevent and to lessen cardiovascular disease, an expert panel has developed guidelines based on the latest research. It is a comprehensive plan aimed at reducing the risk of disease during childhood. One of the recommendations is that all children have their cholesterol levels checked between the ages of 9 and 11 years, and again at age 18 to 21.
Over the past few years, the recommendation has been to test children who are at risk of having high cholesterol levels, either due to family history of high cholesterol or early heart disease, or due to being overweight or obese. One of the problems with this approach is that the family history is often unknown or inaccurate. Universal screening will hopefully detect all children with elevated cholesterol, since it has been clearly shown that elevated cholesterol during childhood does start the process of cardiovascular damage during childhood as well.
Some disagree with screening every child, feeling that it is unnecessary or not cost-effective. However, given the ease of screening, and the threat to long-term health, it seems like a wise thing to do.
The media is focusing on the cholesterol screening aspect of the guidelines. However, it is a comprehensive set of recommendations, and universal cholesterol screening is only a small part of it. It is a definite change and perhaps some feel that the other recommendations are already being followed. However, that has not been my experience. While my practice already follows most of the other recommendations in this report, many do not. The report is really an effort to start attacking the problem of adult cardiovascular disease during childhood, and that kind of prevention and life-long perspective on health is exactly the kind of thing pediatricians ought to be doing.
