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Should kids get tested for high cholesterol?

It’s a well-known fact that Latinos, one of the fastest growing populations in the United States, suffer from an increased risk of high cholesterol. And with conditions like high cholesterol, diabetes, high blood pressure and obesity compounding risk of cardiovascular disease across all ethnic and racial groups, more doctors than ever are asking whether American children should undergo testing for high cholesterol – their rationale being that early management of high cholesterol through medication might curtail later heart-related issues.

But new criticism released online today in the journal of Pediatrics suggest that children’s cholesterol screening guidelines released by the National Heart Lung and Blood Institute (NHLBI) in December are far too rigid, citing that panel members were unfairly influenced by their financial ties to drug making pharmaceutical companies. The NHLBI guidelines – endorsed by the American Academy of Pediatrics – suggest that all children between the ages of 9 and 11 be screened once for high cholesterol and further recommend that testing start earlier for children with a family history of heart disease and cholesterol problems.

Citing a lack of cost-effective analysis, weak evidence and actual benefits of such screenings, researchers from the University of California at San Francisco stated that “the specific guidelines of which children to screen and treat are based on expert opinion and not firmly backed by clinical trials, observational studies, or even modeling.” Furthermore, the team lead by Thomas B. Newman, MD, MPH, cited NHLBI panel members’ “financial relationship with companies making lipid-lowering drugs and lipid-testing instruments” as factors constituting a conflict of interest.

Doctors like Nelly Maseda, a pediatrician who practices at Montefiore Medical Center at the University Hospital for Albert Einstein College of Medicine, says that while financial ties between medical professionals and drug companies are not uncommon, what matters most is that Latino parents understand the importance of childhood cholesterol screening for overweight children and kids with a family history of cardiovascular disease.

“The real question here is how young should children undergo testing,” explains Dr. Maseda, who is based in the Bronx, an area of New York City whose population is over half Latino. “I personally feel that any school-aged child should know their cholesterol. And if a child does have high cholesterol, clinicians can often use that as a wake-up call to counsel parents about the importance of a healthy lifestyle.”

Explaining that healthy amounts of “good” cholesterol – high-density lipoproteins – are needed for early brain development for children under two, Dr. Maseda says that cholesterol screening should begin when children approach elementary school age or when their consulting pediatrician deems appropriate.

“Parents should talk to their doctor and understand that if their child is obese, this test may be a way to manage further complications,” says Dr. Maseda. “The reality is that pharmaceutical companies will make money off cholesterol drugs, but the finger-pointing and yelling has to stop.”

“What matters most is the health of our Latino children,” notes Dr. Maseda. “As it stands, there are children right now who can benefit from cholesterol screening, and that’s what parents should keep in mind.”

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