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August 1990, Vol 144, No. 8 >
Article | August 1990

Children Should Not Be Routinely Screened for High Blood Cholesterol FREE

THOMAS B. NEWMAN, MD, MPH; WARREN S. BROWNER, MD, MPH; STEPHEN B. HULLEY, MD, MPH
Am J Dis Child. 1990;144(8):851. doi:10.1001/archpedi.1990.02150320013007.
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To the Editor.—We disagree with Dr Strong's1 recommendation that pediatricians screen all children for high blood cholesterol. Our opposition to childhood cholesterol screening is based on an assessment of the evidence as to the benefits and adverse effects of such a policy.

Proponents of screening believe that identifying children with high blood cholesterol conveys information about their risk of developing coronary heart disease (CHD) many decades later, and that this could lead to interventions that would prevent CHD more effectively if begun in childhood than if begun as an adult. However, the evidence does not support this belief. For one thing, even in carefully performed research studies the association between cholesterol measured in childhood and cholesterol measured only 10 to 20 years later is far from perfect. In the Muscatine study,2 for example, fewer than half of the children with cholesterol in the top 10% of the

REFERENCES

1 +
Strong WB.  You are a preventive cardiologist: the scope of pediatric preventive cardiology . AJDC . 1989;;143:1145.
2 +
Lauer RM, Lee J, Clarke WR.  Factors affecting the relationship between childhood and adult cholesterol levels: the Muscatine study . Pediatrics . 1988;;82:309-318.
3 +
American Academy of Pediatrics, Committee on Nutrition.  Indications for cholesterol testing in children . Pediatrics . 1989;;83:141-142.
4 +
Rivin AR.  Total and high-density lipoprotein cholesterol measurements: hazards in clinical interpretation . West J Med . 1989;;151:289-291.
5 +
Lipid Research Clinics Program.  The lipid research clinics coronary primary prevention trial results, II: the relationship of reduction in incidence of coronary heart disease to cholesterol lowering . JAMA . 1984;;251:365-374.
6 +
Lifshitz F, Moses N.  Growth failure: a complication of dietary treatment of hypercholesterolemia . AJDC . 1989;;143:537-542.
7 +
Oliver MF.  Risks of correcting the risks of coronary disease and stroke with drugs . N Engl J Med . 1982;;306:297-298.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Strong WB.  You are a preventive cardiologist: the scope of pediatric preventive cardiology . AJDC . 1989;;143:1145.
2 +
Lauer RM, Lee J, Clarke WR.  Factors affecting the relationship between childhood and adult cholesterol levels: the Muscatine study . Pediatrics . 1988;;82:309-318.
3 +
American Academy of Pediatrics, Committee on Nutrition.  Indications for cholesterol testing in children . Pediatrics . 1989;;83:141-142.
4 +
Rivin AR.  Total and high-density lipoprotein cholesterol measurements: hazards in clinical interpretation . West J Med . 1989;;151:289-291.
5 +
Lipid Research Clinics Program.  The lipid research clinics coronary primary prevention trial results, II: the relationship of reduction in incidence of coronary heart disease to cholesterol lowering . JAMA . 1984;;251:365-374.
6 +
Lifshitz F, Moses N.  Growth failure: a complication of dietary treatment of hypercholesterolemia . AJDC . 1989;;143:537-542.
7 +
Oliver MF.  Risks of correcting the risks of coronary disease and stroke with drugs . N Engl J Med . 1982;;306:297-298.

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