Most people don’t associate heart disease with children, and although it’s relatively rare, certain risk factors in childhood can increase a kid’s chances of developing heart and blood vessel problems as they get older. Some studies have shown that narrowing and hardening of the arteries can even begin in childhood.
Last month’s annual Scientific Session of the American College of Cardiology presented disturbing research about kids at risk for developing cardiovascular problems — approximately 1 in 3 children between the ages of 9 and 11 who received cholesterol screenings showed borderline or high results.
As summarized on ScienceDaily.com, the study was one of the largest of its kind, involving outpatient clinic visits of the Texas Children's Pediatrics Associates. It examined more than 12,700 medical records of children whose routine physical exams included screening for cholesterol.
The study’s lead researcher, Dr. Thomas Seery, a pediatric cardiologist, said "The sheer number of kids with abnormal lipid profiles provides further evidence that this is a population that needs attention and could potentially benefit from treatment. But we can only intervene if we diagnose the problem."
Seery said it’s important to identify kids with high levels of blood cholesterol/fats and to lower their blood values in order to stave off the chances of future disease.
The study showed that boys were more likely than girls to have elevated total cholesterol, low-density lipoprotein (LDL, or "bad" cholesterol) and triglycerides (blood fats), but girls had lower high-density lipoprotein (HDL, or "good" cholesterol).
No surprise that obese children were more likely to have elevated total cholesterol, LDL and triglycerides, and lower HDL than were kids who weren’t obese.
You don’t know if your child’s values are normal, of course, unless they’re measured. The National Heart Lung and Blood Institute guidelines recommend universal cholesterol screening of children between the ages of 9 and 11, and again between 17 and 21. That practice is endorsed by the American Academy of Pediatrics. (See our blog, “Cholesterol Tests for Kids.”)
Like all screenings, however, this one isn’t without concern for overtreatment if a result isn’t precisely within what’s considered normal. Seery’s aware of that. "There is concern by some in the medical community that children will be started on medication unnecessarily," he said. So the first line of defense against rising blood cholesterol is for youngsters to adopt a healthful diet and to exercise regularly.
Seery said that cholesterol-lowering drugs usually aren’t necessary except for 1 or 2 children in 100 who have very high cholesterol, usually because of a genetic disorder. Such problems, including inherited high cholesterol, can be detected in childhood, but might be underdiagnosed. But if blood is tested at the recommended ages, it will be found.
The universal pediatric screening guidelines were initiated at the end of 2011, during the second year of the research. So one of the study’s limitations might be that we don’t know if testing was ordered for everybody, as a matter of course, or only for select subjects chosen for their individual risk factors or family history of premature heart disease.
Other studies have demonstrated that screening based on family history alone can overlook children who have abnormally high cholesterol. So further research is needed in order to determine how many health-care providers are following the guidelines, and how consistently they do so.