Cholesterol detection, diagnosis and evaluation.

Children with parents who have premature cardiovascular disease often have high serum cholesterol levels. In order to prevent the formation of atherosclerotic lesions in the coronary arteries, efforts are called for identifying, treating and monitoring individual children and adolescents who have high serum cholesterol levels. The screening of children should be performed in the context of their continuing health care and particularly, adolescents who smoke cigarettes, have high blood pressure, or consume excessive amounts of saturated fatty acids, total fat and cholesterol and who are overweight should be subjected to cholesterol testing. On the basis of the data presented in this article, it will be prudent to test high serum cholesterol in all young people whose parents have a total serum cholesterol exceeding 240 mg/dl. A total serum cholesterol level of equal to or greater than 200 mg/dl or an LDL cholesterol level of equal to or greater than 130 mg/dl when associated with family history or parental hypercholesterolemia warrants further evaluation. Children and adolescents with high LDL cholesterol levels that are equal to or greater than 130 mg/dl should be considered to be possible secondary causes of hypercholesterolemia and therefore continuous monitoring and clinical evaluation of this population may be necessary. Other factors such as familial hyperlipidemia, hypoalphalipoproteinemia, diabetes and high alcohol intake also need careful assessment.