One in three American kids may have high cholesterol in a worrying portent for the future generation’s health.
In one of the largest studies of its kind, Thomas Seery, a pediatric cardiologist at Texas Children’s Hospital who teaches at Baylor’s medical school, analyzed the outpatient records of nearly 13,000 children. As part of routine physical exam, all kids ages 9 to 11 visiting health clinics operated by the Texas Children’s Pediatrics Associates received cholesterol screenings.
Of those kids, 30 percent tested high for cholesterol, with measurements of borderline or elevated total cholesterol as defined by the U.S. government’s national cholesterol education program.
"The sheer number of kids with abnormal lipid profiles provides further evidence that this is a population that needs attention and could potentially benefit from treatment," Seery said in a statement. "But we can only intervene if we diagnose the problem."
Although cardiovascular disease rarely develops in children, risk factors may build over time. In evidence presented Sunday to the American College of Cardiology’s annual meeting, Seery noted scientific study suggesting that a hardening and narrowing of the arteries known as atherosclerosis may begin as early as childhood.
"We know that higher levels of, and cumulative exposure to, high cholesterol is associated with the development and severity of atherosclerosis," Seery said. "If we can identify and work to lower cholesterol in children, we can potentially make a positive impact by stalling vascular changes and reducing the chances of future disease."
Screening more children for cholesterol is especially important as the childhood obesity rate continues to grow after more than quadrupling among adolescents since the 1960s, according to figures from the Centers for Disease Control and Prevention. Today, one in three adolescents is overweight with approximately 18 percent obese. Seery says that epidemic means more kids with dyslipidemia, or abnormally high amounts of cholesterol or fats in the blood.
In the study, boys were found to be more likely than girls to have higher levels of total cholesterol as well as elevated levels of low-density lipoprotein, the so-called “bad cholesterol,” along with greater levels of triglycerides. However, girls had lower levels of “good cholesterol,” the high-density lipoprotein. And obese children had it worst with higher levels of bad cholesterol and triglycerides along with lower levels of good cholesterol.
Hispanic children, too, were more likely to have elevated triglyceride levels and lower levels of good cholesterol.
Seery says he hopes his study provides evidence to support guidelines introduced in 2011 by the National Heart Lung and Blood Institute, which have also been endorsed by the American Academy of Pediatrics. Those new guidelines implore health systems to institutionalize cholesterol screenings for children ages 9 to 11 and then for young adults ages 17 to 21.
However, some clinicians fear greater cholesterol screenings may mean putting children on medication. "There is concern by some in the medical community that children will be started on medication unnecessarily," Seery said, noting that he supported more natural interventions with changes in diet and exercise.
"Kids need to have their cholesterol panel checked at some point during this timeframe [9 to 11 years old]," Seery said. "In doing so, it presents the perfect opportunity for clinicians and parents to discuss the importance of healthy lifestyle choices on cardiovascular health. Our findings give a compelling reason to screen all kids' blood cholesterol."
Seery says further research should investigate the compliance rate among pediatricians following the introduction of the new cholesterol screening guidelines.