Cholesterol Screening among Children and Their Parents

Background. The Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) project is designed to test the hypothesis that universal cholesterol screening of prepubertal schoolchildren is effective in identifying children and their parents at risk of developing premature coronary heart disease (CHD) in a high-risk rural population. Methods. Seven hundred nine fifth-grade schoolchildren from seven rural Appalachian counties participated in a school-based cholesterol screening program. Family history of premature CHD, anthropometric and blood pressure measurement, tobacco smoke exposure, dietary history, and physical activity levels were collected. Results. One-fourth (174) of the children were “presumptively” dyslipidemic upon measurement of nonfasting finger-stick blood cholesterol (FSC). Subsequent fasting lipid profile obtained for 63 of these children and 79 of their parents confirmed the presence of dyslipidemia in 37 children (59%) and 52 parents (66%). Among confirmed dyslipidemic children, family history was not a good predictor of dyslipidemia (sensitivity 21.6%). FSC levels were significantly correlated with fasting total cholesterol of children and their parents. Conclusions. Universal nonfasting FSC screening of prepubertal schoolchildren is effective in identifying dyslipidemic children and their parents, whereas family history has low sensitivity in predicting children with elevated blood cholesterol concentrations.