All U.S. children should have their cholesterol tested between the ages of 9 and 11, according to new guidelines released Friday.
The recommendation comes from by a 14-member expert panel convened by the National Heart, Lung and Blood Institute and endorsed by the American Academy of Pediatrics, which will publish the panel’s report on Monday in the journal Pediatrics.
The recommendation marks a significant expansion from the 1992 guidelines, which had recommended that children get their cholesterol checked only if there is a history of high cholesterol or early heart disease in their families.
But the panel decided to push for expanded testing because accumulating evidence suggests that high cholesterol in childhood can lead to early signs of heart disease and that the current approach could leave some children at risk, said Stephen R. Daniels of the University of Colorado, who led the panel.
“There have been studies showing the targeted approach doesn’t work that well and misses some children with high cholesterol who would benefit from diet and exercise,” Daniels said in an interview.
Most children found to have high cholesterol would be able to control it by improving their diets and exercising more, he said. A small proportion might have to take the widely used class of cholesterol drugs known as statins, which have been shown to be safe and effective in children, the panel said.
“Adverse effects on growth, development, or sexual maturation were not seen,” in children who took statins, the report said, “and adverse-event profiles and efficacy were similar to those in studies of adults.”
Despite reports to the contrary, the change was not prompted by the obesity epidemic, Daniels said. While obesity can increase the risk for high blood pressure in children, so far there is no evidence that it is also raising kids’ cholesterol levels.