Test the Child, Uncover the High-Risk Parent: A Call to Expand Universal Pediatric Lipid Screening

Pediatric lipid screening remains underutilized, despite recommendations from many professional societies. In particular, certain lipid disorders such as familial hypercholesterolemia and elevated lipoprotein (a) are highly heritable and detectable in childhood. This low uptake represents not only a missed opportunity to identify high-risk youth for atherosclerotic cardiovascular disease (ASCVD), but also a lost occasion to identify high-risk adult relatives through reverse cascade screening. Expanding universal pediatric lipid screening to include lipoprotein (a) can serve as an effective strategy to uncover undiagnosed ASCVD in their relatives. Early identification of affected, asymptomatic individuals could prevent ASCVD morbidity and mortality.