Updated June 08, 2015.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
Risk factors for atherosclerotic cardiovascular disease (CVD), such as stroke and heart attacks, often begin in childhood. That makes it important to begin screening for those risk factors - including high cholesterol levels - in childhood, especially since CVD is a leading cause of death in the United States.
With the latest guidelines from the American Academy of Pediatrics, all kids should get screened when they are between ages 9 and 11 and again when they are 17 to 21 years old.
Specifically, all of these kids should have cholesterol screening to include a non-fasting, non-HDL cholesterol level, which is a calculated value that is equal to your total cholesterol minus your HDL cholesterol level. As an alternative to a non-fasting, non-HDL level, a fasting lipid profile can be done.
A non-fasting, non-HDL cholesterol level, which includes your LDL and triglyceride levels, is now thought to be the most likely to predict who might later have problems because of high cholesterol levels.
In children and teens, a non-fasting, non-HDL cholesterol level is considered:
If the level is high, a fasting lipid profile should be done twice, at least two weeks apart, but within three months, with the results averaged together.
Your pediatrician can then use these results to help figure out if your child indeed has high cholesterol and if he or she needs further management.
These high-risk kids should have a fasting lipid profile when they are between the ages of 2 and 8. Older kids, between the ages of 12 and 16, should also be tested if they are discovered to be at high risk. Whenever it is done, to be accurate, the fasting lipid profile should be done twice, with the results averaged together.
In children and teens, levels are considered high if they are:
However it is important to get your kids tests, as identifying children with high cholesterol levels and working to control them (dietary advice, risk factor control, medications or referral to a lipid specialist, etc.) can decrease their risk of cardiovascular disease as adults.
Also, simply trying to test those children with risk factors can miss a lot of children with high cholesterol levels, which makes universal cholesterol screening important.
Sources:
American Academy of Pediatrics. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report. Pediatrics. Volume 128, Supplement 6, December 2011.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
Risk factors for atherosclerotic cardiovascular disease (CVD), such as stroke and heart attacks, often begin in childhood. That makes it important to begin screening for those risk factors - including high cholesterol levels - in childhood, especially since CVD is a leading cause of death in the United States.
Universal Cholesterol Screening
Cholesterol screening was once something that was just done if a child or teen had risk factors, such as being overweight or having a family history for high cholesterol levels.With the latest guidelines from the American Academy of Pediatrics, all kids should get screened when they are between ages 9 and 11 and again when they are 17 to 21 years old.
Specifically, all of these kids should have cholesterol screening to include a non-fasting, non-HDL cholesterol level, which is a calculated value that is equal to your total cholesterol minus your HDL cholesterol level. As an alternative to a non-fasting, non-HDL level, a fasting lipid profile can be done.
A non-fasting, non-HDL cholesterol level, which includes your LDL and triglyceride levels, is now thought to be the most likely to predict who might later have problems because of high cholesterol levels.
In children and teens, a non-fasting, non-HDL cholesterol level is considered:
- Acceptable if it is less than 120mg/dl
- Borderline-High if it is between 120 to 144 mg/dl
- High if it is greater than or equal to 145 mg/dl
If the level is high, a fasting lipid profile should be done twice, at least two weeks apart, but within three months, with the results averaged together.
Your pediatrician can then use these results to help figure out if your child indeed has high cholesterol and if he or she needs further management.
Cholesterol Screening for High-Risk Kids
In addition to the universal screening guidelines, many children need their cholesterol tested if they are at high risk, including children with:- a male parent, grandparent, uncle or sibling who had an MI (myocardial infarction or heart attack), angina, stroke or CABG/stent/angioplasty before the age of 55
- a female parent, grandparent, aunt or sibling who had an MI, angina, stroke or CABG/stent/angioplasty before the age of 65
- a parent who has a total cholesterol at or above 240 mg/dL or known dyslipidemia (high cholesterol levels)
- diabetes, high blood pressure, BMI greater than or equal to the 95th percentile (overweight and obese kids) or a history of smoking cigarettes
- a moderate or high-risk medical condition, such as having had a kidney transplant or heart transplant, chronic kidney disease, end-stage renal disease, Kawasaki disease, chronic inflammatory disease (SLE, JRA, etc.), HIV infection or nephrotic syndrome
These high-risk kids should have a fasting lipid profile when they are between the ages of 2 and 8. Older kids, between the ages of 12 and 16, should also be tested if they are discovered to be at high risk. Whenever it is done, to be accurate, the fasting lipid profile should be done twice, with the results averaged together.
In children and teens, levels are considered high if they are:
- greater than or equal to 200 mg/dl for total cholesterol
- greater than or equal to 130 mg/dl for LDL cholesterol
- greater than or equal to 100 mg/dl for triglycerides (
- greater than or equal to 130 mg/dl for triglycerides (10 to 19 years old)
- and the HDL level is considered low if it is less than 40 mg/dl.
Cholesterol Screening Guidelines
Although getting their own cholesterol tested is something most parents expect when they go to their doctor, they are likely not used to the idea that their kids need to get tested, too.However it is important to get your kids tests, as identifying children with high cholesterol levels and working to control them (dietary advice, risk factor control, medications or referral to a lipid specialist, etc.) can decrease their risk of cardiovascular disease as adults.
Also, simply trying to test those children with risk factors can miss a lot of children with high cholesterol levels, which makes universal cholesterol screening important.
Sources:
American Academy of Pediatrics. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report. Pediatrics. Volume 128, Supplement 6, December 2011.