Performing universal cholesterol screening rather than limiting testing to children with a family history of hyperlipidemia will help prevent atherosclerotic disease, contend researchers who analyzed data from 20,266 fifth-graders participating in the Coronary Artery Risk Detection in Appalachian Communities Project.

Family histories and fasting lipid profiles were used to determine the relationship between hyperlipidemia and family history of the condition and predict the need for pharmacologic treatment among kids with dyslipidemia. It was shown that 71.4% of the children met the National Cholesterol Education Program guidelines for cholesterol screening based on a positive family history. Within that group, 8.3% were considered to have dyslipidemia (LDL >130 mg/dL), and 1.2% had LDL levels >160 mg/dL—potentially high enough to require drug treatment.

Among those with no positive family history for dyslipidemia, 9.5% had dyslipidemia, with 1.7% of these cases warranting pharmacologic intervention.

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“Sensitivity and specificity demonstrated that family history does not provide a strong indication as to whether pharmacologic treatment may be warranted,” cautioned the researchers (Pediatrics. 2010;126:260-265). “The use of universal cholesterol screening would identify all children with severe dyslipidemia, allowing for proper intervention and follow-up and leading to the prevention of future atherosclerotic disease.”

Another study showed an independent association between nonoptimal levels of LDL and HDL in people aged 18 to 30 years and the development of coronary atherosclerosis two decades later (Ann Intern Med. 2010;153:137-146).

Finally, a study involving 12,476 children and adolescents indicated that exposure to perfluoroalkyl acids appears to elevate total and LDL cholesterol levels (Arch Pediatr Adolesc Med. 2010;164:860-869). The specific compounds in question—perfluorooctanoic acid and perfluorooctanesulfonate—are used in nonstick cookware and waterproof fabrics.