Cholesterol screening among children and their parents

Area of Science:

• Pediatric Cardiology
• Public Health
• Preventive Medicine

Background:

• The Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) project addresses high rates of premature coronary heart disease (CHD) in a rural population.
• Focuses on testing universal cholesterol screening in prepubertal children to identify at-risk individuals and families.

Purpose of the Study:

• To evaluate the effectiveness of universal cholesterol screening in prepubertal schoolchildren.
• To identify children and parents at risk for premature coronary heart disease (CHD).

Main Methods:

• A school-based cholesterol screening program involving 709 fifth-grade students in rural Appalachian counties.
• Data collection included family history of CHD, anthropometrics, blood pressure, environmental exposures, diet, and physical activity.

Main Results:

• One-fourth of students showed presumptive dyslipidemia via nonfasting finger-stick cholesterol (FSC).
• Confirmatory testing revealed dyslipidemia in 59% of children and 66% of parents.
• Family history had low sensitivity (21.6%) for predicting dyslipidemia in children; FSC correlated with fasting cholesterol levels.

Conclusions:

• Nonfasting FSC screening in schoolchildren is effective for identifying dyslipidemic children and their parents.
• Universal screening surpasses family history in detecting elevated cholesterol in children.
• Highlights the utility of school-based screening for early detection of cardiovascular risk factors in high-risk rural populations.