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Last Updated: Thursday, 13 September 2007, 23:00 GMT 00:00 UK
Children cholesterol test call
Young child
Children should receive a cholesterol test, say experts
Children should receive a cholesterol test alongside their routine vaccinations at the age of 15 months, experts say.

The tests would identify those with an inherited cholesterol disorder which increases the risk of heart disease.

Parents of affected children would also be tested and treated, the British Medical Journal article states.

Various screening options, including DNA testing, are being considered by the government's health watchdog.

Familial hypercholesterolaemia is an inherited condition which affects about one in 500 people in which the body does not get rid of cholesterol in the usual way and it accumulates.

What this proposal does is suggest a way of picking up most cases in the population as whilst you're doing it in children you reach their parents as well
Dr David Wald

Adults aged 20-39 years with the condition have a 100-fold increased risk of dying from coronary heart disease.

But treatment with statins to lower cholesterol reduces the risk substantially.

A nationwide screening programme is being piloted in relatives of adults diagnosed with the familial hypercholesterolaemia but about four-fifths of people with the condition would not be found this way.

Analysis of 13 studies by researchers at Barts and the London Queen Mary's School of Medicine suggests testing children would identify most cases of the disorder.

Cholesterol tests in children between the age of one and nine years are the most accurate because as people get older their cholesterol gets higher for other reasons, such as an unhealthy diet, they say.

And the most obvious time to do the screening, which would involve a blood spot test, would be when children present for their routine vaccinations at 15 months.

Double hit

For every child with the condition, one parent would also have to be affected and they could also be tested and treated.

Study leader Dr David Wald, a consultant cardiologist, said: "What this proposal does is suggest a way of picking up most cases in the population as whilst you're doing it in children you reach their parents as well."

He added that although children would probably not be treated with statins until they were older they could help their risk, like anyone, by keeping a healthy weight, doing exercise, not smoking and eating a diet low in saturated fat.

The team are planning a pilot to assess feasibility and staff and parent acceptance.

The National Institute of Clinical Excellence is also looking at the issue and is due to report at the end of this year on what would be the best method for identifying those with the condition.

Dr Tony Wierzbecki, chairman of Heart UK's medical scientific and research committee, said in theory it was a good idea although tests were probably even more accurate in four to six year olds.

"In children you can be fairly certain that high cholesterol is mainly due to inherited disorders.

"But I don't think there's any consensus about what age you should screen for cholesterol.

"Worldwide the view is we need to be looking for family history of early heart disease and in these people it is worthwhile doing cholesterol checks."

He added that there were also genetic tests for the gene defect which causes the condition.

June Davison, cardiac nurse at the British Heart Foundation, said: "It's estimated that only around 10% of the predicted 110,000 people with FH are currently identified.

"All approaches should be considered, because - once identified - the condition can be treated and the consequences may be prevented."


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