What are the NHLBI guidelines on pediatric lipid screening?

Updated: Jun 27, 2019
  • Author: Henry J Rohrs, III, MD; Chief Editor: Stuart Berger, MD  more...
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National Heart, Lung, and Blood Institute

In 2011, the National Heart, Lung, and Blood Institute (NHLBI) released pediatric lipid screening and cardiovascular health recommendations. [19] These guidelines agree with most of those from the NCEP but are more specific, recommending precise ages and more aggressive repeat testing and therapy in high-risk patients. The evidence-based recommendations suggest no routine lipid screening before age 8 years.

In children aged 2-8 years who are considered to be at higher risk (eg, children with a family history of early cardiovascular disease or a parent with a TC level of 240 mg/dL or higher or known dyslipidemia; children with diabetes, hypertension, or a BMI ≥95th percentile; children who smoke cigarettes), fasting lipid profiles should be obtained on two separate occasions and the results averaged. Universal screening is recommended for low-risk individuals at age 9-11 years and again at age 17-21 years.

These recommendations for universal screening, while controversial, recognize the preponderance of evidence that high LDL-C levels are a significant contributor to heart disease, although they do not consider the lack of evidence as to whether the benefits of lifelong treatment with lipid-lowering drugs outweigh the treatment risks. [19]

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