Ask the Expert: Does My Child Need to Be Screened for High Cholesterol?

We asked Anthony F. Porto, M.D., M.P.H., director of pediatric gastroenterology at Greenwich Hospital in Greenwich, CT, and assistant professor of pediatrics, Yale Medical Group. Read Dr. Porto's advice on what age kids should be tested for high cholesterol, what the risk factors are for developing high cholesterol at an early age, and how to prevent the diseases caused by high cholesterol.

High cholesterol is a risk factor for coronary heart disease in adults, but some children may be at risk for premature coronary heart disease if they have high cholesterol levels earlier in life. The National Lipid Association has issued new guidelines stating that all children between 9 to 11 years of age should be screened for high cholesterol. In addition, children with a family history of premature heart disease and high cholesterol should be screened at age 2. 

Heterozygous familial hypercholesterolemia (FH) is an inherited condition that occurs as frequently in 1 in 500 people. Children with one parent with FH have a 50 percemt chance of inheriting FH. It is associated with high cholesterol, particularly high LDL ("bad") cholesterol. With high amounts of "bad" cholesterol in the blood, individuals are at increased risk for premature atherosclerosis (hardening of the arteries) and may develop heart disease, myocardial infarctions (heart attack), and strokes at an early age. Because individuals with FH are often asymptomatic for years, people can go undiagnosed for years and present only after years of disease progression. The earlier that someone is diagnosed, the better it is for long-term health.