How desirable is Targeted Blood Cholesterol Screening among Youth as Compared to Universal Screening

The problem of hyperlipidemia and atherosclerosis, leading to various cardiovascular diseases, is spreading like an epidemic in both developed and under developed countries. It has been realized that these problems take a root in childhood itself. In 2008, the American Academy of Pediatrics (AAP) called upon pediatricians to screen all those children for high cholesterol levels whose parents had a history of hypercholesterolemia or cardiac disease before the age of 55 or were obese and hypertensive. But now, a new study by Ritchie et al has shown that this targeted screening of children for blood cholesterol levels may miss out on many other affected children.

Susan K. Ritchie, along with her co-workers from the West Virginia University carried out a study to test the effectiveness of targeted screening for identifying children with severe or genetic hyperlipidemia. The researchers analyzed data of about 20,000 children involved in the CARDIAC project from Sept 2003 to April 2008. They found that out of these children, 71.4% met the parameters to be screened on the basis of guidelines set by AAP. Of these, 8.3% had LDL level of more than 130mg/dL while 1.2% had LDL more than 160mg/dL. Of the children who would have been left out according to current guidelines, 9.5% had LDL higher than 130mg/dL while 1.7% had LDL more than 160mg/dL. It was found that if treatment is considered for all children with an LDL level of more than 160mg/dL and the current screening parameters laid down by AAP are strictly adhered to, then around one third of the children would miss the treatment.

On the basis of the findings of the study, the researchers have recommended that although universal screening of youth for blood cholesterol levels is a difficult proposition, it is essential in order to identify the maximum number of children and teens at risk because of hyperlipidemia. Once these children are identified, they may be appropriately treated and followed up so that they do not develop atherosclerotic and coronary artery diseases in the future.

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