Family Cholesterol

Family history of high cholesterol increases the risk for siblings and children. In some cases, however, there is a definite genetic link associated with elevated cholesterol. Researchers say this condition, called familial hypercholesterolemia, affects about two out of every 1,000 people. Patients tend to have very high cholesterol levels and are at increased risk for early death from heart disease. In fact, young adults (20 to 39) with familial hypercholesterolemia are 100 times more likely to die from coronary artery disease.

Even for children without familial hypercholesterolemia, high cholesterol can have serious consequences for their adult health. Many children with elevated cholesterol levels will continue to have the problem as adults. And earlier development of the problem may mean they will be at risk for artery-clogging plaque and heart attacks at a much younger age.

Health experts don’t recommend mass screening for cholesterol in children. Children under two need cholesterol for their growing bodies. After age two, screening may be warranted if a child has a family history of high cholesterol (over 240 mg/dL) or early heart disease, heart attack or stroke.

Julie Brothers, M.D., a Pediatric Cardiologist with The Children's Hospital of Philadelphia, says in addition to family history, some cases of elevated cholesterol are caused by lifestyle factors, namely diet and obesity. Thus, cholesterol screening may also be recommended for children who are overweight or who have diabetes or high blood pressure. Cholesterol screening may also be beneficial for teens who smoke and those taking oral contraceptives or retinols for acne (these medications can sometimes raise cholesterol levels).

Children can be placed on a cholesterol-lowering diet after age two. Brothers says it’s usually easier to start these changes at a young age, before children develop a taste for fast food. Parents can keep supplies of ready to eat healthy snacks, like apple slices and cut veggies, instead of providing chips, pastries and other unhealthy foods. It’s also easier if the entire family gets involved in making the dietary changes a permanent part of a healthy lifestyle.

Brothers says, in extreme cases, there are medications to help lower cholesterol in children. A statin drug may be given to boys as young as ten and girls after they begin menstruation.