Canadian pediatricians call for cholesterol checks for kids as young as 2 to catch heart risks early
CBC
The Canadian Paediatric Society is recommending cholesterol screening for all children between two and 10 years old.
A position statement released by the society on Friday says atherosclerosis — the buildup of plaque, which includes cholesterol, in the arteries — starts in childhood and is a key driver of heart disease and stroke.
The statement's lead author, pediatric cardiologist Dr. Michael Khoury, says about one in 300 Canadians have high cholesterol caused by a genetic condition called familial hypercholesterolemia (FH).
He says universal screening with a blood test would allow doctors to identify the condition early and begin treatment, including changes to diet and physical activity.
Treating the condition in childhood can prevent cardiovascular illness from appearing in adulthood, says Khoury, who specializes in preventive cardiology at the Stollery Children's Hospital and the University of Alberta in Edmonton.
He says without universal screening, doctors are missing about 95 per cent of children who have FH because children don't tend to have any symptoms.
Dr. Alykhan Abdulla, a family doctor in Manotick, Ont., agrees there's a lot of value in screening and preventative treatment.
"We have to start moving away from disease care, where we look after people who are sick … we need to move further upstream in areas of preventative health care," he said.
However, he worries about the impact any new screening would have on resources. Getting thousands of children scheduled for blood tests and having proper follow-up would strain an already stretched system, he said.
"[And] if we find these things — three-, four-, five- thousand new people, young children who have high cholesterol — we have to get them fitness help, dietetics help," said Abdulla.
"Those things will be resource heavy, but they'll be things that we should invest in."
FH is most commonly caused by a mutation in the low-density lipoprotein cholesterol (LDL) receptor on the liver. The mutation prevents LDL cholesterol — often called "bad" cholesterol — from getting into the liver, so it accumulates in the blood, says Khoury.
It also causes the liver to detect a "low cholesterol environment" and ramp up cholesterol production.
LDL cholesterol, along with fat and other substances, is a major component of plaque that builds up in the arteries and limits blood flow to the heart and brain.
