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The validity of screening for hypercholesterolaemia at different ages from 2 to 17 years.

Summary: This study was designed to test the proposition that an optimal age for screening for hypercholesterolaemia (HC) might be defined. The samples of children studied included 200 two-year-olds, 385 four-year-olds, and 230 primary and secondary children aged from eight to 17 years. 
 
 
 
The 95th percentile value for total serum cholesterol (TC) was used to define HC in children and to select children for family studies. Four of the 15HC two-year-olds had an HC parent with three having a history of early coronary heart disease (CHD). Twenty-three of the 310 parents sampled had HC, 15 having a family history of early CHD, but only four having an HC child. 
 
 
 
Family studies were done on 20 HC four-year-olds of whom half had a positive family history of premature coronary heart disease (CHD). Half of each group of parents were HC, but probable familial hypercholesterolaemia (FH) was detected only in three parents, environmental causes accounting for the HC of the others. 
 
 
 
Four primary and five secondary school students were HC, and selected for family studies. A positive family history of CHD was present in two of the primary and all of the secondary students, with five of the seven families having one or more HC parent, one having probable FH. 
 
 
 
It is proposed that programmes for detecting HC in childhood become valid only from four years of age, and that the presence of a positive family history of early CHD would reduce the proportion of children to be tested to a practical level without significantly impairing the accuracy of the case finding procedure. School entry might provide a suitable time to identify children with HC.