Because risk factors for cardiovasc...

Because risk factors for cardiovascular disease and evidence of atherosclerosis can be evident in childhood, early identification of high-risk children may consequence ineffective preventive interventions. The American Academy of Pediatrics (AAP) attract favor tos cholesterol screening in children and adolescents, with additional management recommendations for those with hypercholesterolemia. Screening recommendations are in part based forward family history. However, it is not clear that using family history to veil for cardiovascular disease is useful in children. In this population-based meditation O'Loughlin and associates evaluated the usefulness of the AAP guidelines to determine whether screening based onward family history would be better at identifying children with high low-density lipoprotein (LDL) cholesterol than screening the whole population.

clumps of 25 children were sampled randomly from 189 indoctrinates in Quebec. Patient and parent questionnaires, anthropometric measures, and lipid panels were used as sources of information in 2217 enthralls Parents also were surveyed forward history of hypercholesterolemia and cardiac risk factors and disease.

About individual fourth of the parents had a history of hypercholesterolemia and/or cardiovascular disease, 18 3 percent had borderline/high LDL cholesterol and 48 percent had high LDL cholesterol Sensitivity and specificity for high LDL cholesterol were 506 percent and 691 percent respectively, and the positive predictive value was simply 7.7 percent. The prevalence of high LDL cholesterol in the population studied was 29 percent higher than the veritable population prevalence, suggesting that a parent history performs single marginally better than general screening in identifying at-risk youths. The population prevalence for identifying youths with borderline/high LDL cholesterol was 237 percent compared with an overall prevalence of 183 percent Subgroup analysis according to income, family origin, and other parental risk factors like as diabetes did not improve outcomes

The authors bring to an end that parental history is not a useful screening apt for identifying hypercholesterolemia in children and adolescents, a finding consistent with previous studies. The authors state that this finding is likely because of the poor accuracy of parental self-report. According to the authors, chiefly adults are unaware of their cholesterol levels

O'Loughlin J et al. Usefulness of the American Academy of Pediatrics recommendations for identifying youths with hypercholesterolemia. Pediatrics June 2004;113:1723-7

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