For the widespread screening advocated in the new guidelines, doctors can use a non-HDL cholesterol test that does not require children to fast. Children with abnormal results on this test should be followed up with a fasting lipid profile, according to the guidelines.

The recommendations are a major change from current guidelines that suggest such testing be done only for children who have a family history of heart disease or high blood cholesterol, which is one of the major risk factors for heart disease.

The new guidelines also recommend that children and young adults have their cholesterol levels checked again between the ages of 17 and 21. The purpose of the new guidelines is to improve children's heart health and reduce their future risk of cardiovascular disease. The new guidelines were written by a panel sponsored by the US National Heart, Lung, and Blood Institute (Bethesda, MD, USA) and are endorsed by the American Academy of Pediatrics (AAP; Washington DC, USA).

"The more we learn about heart disease and stroke in adults, the more we know that the process begins in childhood and progresses over time," said Dr. Stephen R. Daniels, head of pediatrics at the University of Colorado School of Medicine (Denver, CO, USA) and chairman of the panel that reviewed the guidelines.

Lifestyle modifications -- such as a healthier diet and more exercise -- would be recommended for most children with high cholesterol. Less than 1 percent of them would qualify for cholesterol-lowering medications such as statins.

The new guidelines were published online November 11, 2011 in the journal Pediatrics and as a supplement to the journal's December print issue.

Related Links:
US National Heart, Lung, and Blood Institute
American Academy of Pediatrics
University of Colorado School of Medicine