Children could have their cholesterol levels tested at about 15 months of age to prevent heart disease later in life, say doctors in a study published in BMJ today.
High cholesterol which runs in families is known as familial hypercholesterolaemia. It affects about two in every 1000 people and causes very high levels of low density lipoprotein (LDL) or ‘bad cholesterol’ in the blood. It carries a high risk of death from coronary heart disease.
Treatment to lower cholesterol reduces the risk substantially, but there is uncertainty over what screening strategy is likely to be effective.
So researchers at Barts and the London Queen Mary's School of Medicine and Dentistry analysed published studies on total and LDL cholesterol in people with and without familial hypercholesterolaemia to determine the efficacy of screening and the best age to do this.
They identified 13 studies involving 1,907 cases and 16,221 controls.
They found that screening was most effective if done in early childhood (1-9 years). Screening at this age detected 88% of affected individuals, while screening newborns and young adults was much less effective.
Based on these results, the authors suggest that children could be screened when they visit their general practice for routine vaccinations at about 15 months of age.
Once an affected child is identified, their parents would then also be screened, since, given the inheritance of this disorder, for every affected child there would be one affected parent. Treatment to lower cholesterol could then be initiated immediately in the affected parent and delayed in the child until adulthood.
A potential strength of screening at the time of childhood immunisation, they explain, is that it would take place at a time when parents are receptive to the possibility of preventing disease in their child and therefore may be receptive to a family based strategy to prevent the consequences of the same disease within the family as a whole.
The proposed strategy elegantly screens for familial hypercholesterolaemia in two generations simultaneously with the potential of preventing premature coronary heart disease in nearly everyone with the disorder.
Source: BMJ-British Medical Journal
Related stories:
New chemical tool kit manipulates mitochondria, reveals insights into drug toxicity
Why do nearly 1 million people taking cholesterol-lowering statins often experience muscle cramps? Why is it that in the rare case when a diabetic takes medication for intestinal worms, his glucose levels improve? Is there any scientific basis for the purported health effects of green tea?
18 million men in the United States affected by erectile dysfunction
More than 18 million men in the United States over age 20 are affected by erectile dysfunction, according to a study by researchers from the Johns Hopkins Bloomberg School of Public Health. The prevalence of erectile dysfunction was strongly linked with age, cardiovascular disease, diabetes and a lack of physical activity.
At risk for peripheral arterial disease? Simple quiz provides key so you can circulate better
Ten million Americans have peripheral arterial disease (PAD), and research shows that the highest risk populations include African-Americans (twice as likely to develop clogged leg arteries), seniors (12-20 percent develop PAD) and diabetics (one in three who are over the age of 50 develop PAD). Legs for Life®—a community health and public information program—recommends that older Americans take its free, online self-assessment quiz.
Millions face undiagnosed heart risk say researchers after mass screening
One in three people with a high risk of developing cardiovascular disease (CVD) over the next 10 years have not been diagnosed, according to a major UK study in the September issue of IJCP, the
International Journal of Clinical Practice.
Will screening for cardiovascular problems be effective?
Last week the government in England closed its consultation on the effectiveness of vascular checks for high-risk individuals aged 40-74, to be rolled out in 2009-10, but will this strategy be worthwhile? Experts debate the issue on bmj.com today.
Low vitamin D levels pose large threat to health
Researchers at Johns Hopkins are reporting what is believed to be the most conclusive evidence to date that inadequate levels of vitamin D, obtained from milk, fortified cereals and exposure to sunlight, lead to substantially increased risk of death.
Could arthritis wonder drugs provide clues for all disease?
Drugs that have helped treat millions of rheumatoid arthritis sufferers may hold the key to many more medical conditions, including atherosclerosis – a leading cause of heart disease – says the researcher who jointly invented and developed them.
Can diet alone control type 2 diabetes? No evidence yet
Despite strong evidence that type 2 diabetes can be prevented or at least delayed by a combination of lifestyle changes and good dietary advice, a team of Cochrane Researchers found that there is no indication whether dietary advice alone can prevent the disease.