Nearly one-third of children may have worrisome levels of cholesterol, putting them at risk for cardiovascular problems decades later, according to a new study.
The study of more than 12,000 9- to 11-year-olds, presented today at the American College of Cardiology's annual conference in Washington, found that 30% of those tested had "borderline" or "abnormal" levels of cholesterol.
"It's a problem that's underdiagnosed," said study author Thomas Seery, a pediatric cardiologist at Texas Children's Hospital and assistant professor at the Baylor College of Medicine, both in Houston.
The greatest predictor of high cholesterol in adulthood, Seery said, is the rate in childhood.
In 2011, an expert panel convened by the National Heart, Lung and Blood Institute issued guidelines that called, among other things, for cholesterol screening of all children before and at the end of adolescence. In the Houston study, researchers found that nearly 5,000 of the children were at risk for or had high cholesterol and roughly the same number were obese. It's not clear whether they were tested for high cholesterol because they had a problem or if their screening was routine.
About 1%-2% of high cholesterol in children is due to inherited problems with cholesterol regulation, Seery said. The rest is caused by obesity, lack of exercise and a poor diet.
"There's no question that we are seeing alarming increases in obesity and elevated cholesterol levels in children and adolescents," said Steven Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic in Ohio, who was not involved in the study.
Nissen said he is not convinced that screening all kids for high cholesterol is an effective way to approach the problem. He's concerned that extra screening will lead doctors to prescribe more medications to children.
Any obese child should be counseled about making lifestyle changes, even without knowing his or her cholesterol levels, Nissen said. There's no proof that screening improves patient health, but it would cost a significant amount to run blood tests on every child, he said.
Seery disagrees, as does Robert Eckel, former president of the American Heart Association. They say universal screening would at least prompt a conversation between doctor and patient about the need for a healthy lifestyle.
"We really need to emphasize prevention, and that begins in childhood," said Eckel, an endocrinologist and professor of medicine at the University of Colorado's Anschutz Medical Campus in Aurora. "This could be a good opportunity to sit down with parents and move them in the right direction."
In other research presented at the conference today, doctors from New York University's Langone Medical Center in Manhattan reported that married adults were less likely to have cardiovascular disease than people who are single, divorced or widowed. The study analyzed data on more than 3.5 million Americans and found that people who are married have a 5% lower risk of having any cardiovascular disease than being single.
In the study of 12,700 9- to 11-year-olds in Houston, researchers found:
•37% had borderline or elevated levels of total cholesterol.
•32% had borderline or low levels of "good" HDL cholesterol.
•36% had borderline or elevated levels of non-HDL cholesterol.
•46% had borderline or elevated levels of triglycerides.