Relying on family history alone to decide which children should be screened for high cholesterol could miss many children who need treatment, according to the study, "Universal Versus Targeted Blood Cholesterol Screening Among Youth: The CARDIAC Project," published in the August print issue of Pediatrics (published online July 12). Researchers analyzed data of more than 20,000 5th grade children in West Virginia, examining their family history and fasting lipid profile. More than 71 percent of the children met guidelines for cholesterol screening based on a family history of premature cardiovascular disease or dyslipidemia (the clustering of moderately elevated total cholesterol, low high-density lipoprotein and high triglycerides). Of those children whose family history did not indicate a need for screening, 9.5 percent had dyslipidemia, and 1.7 percent of these children warranted treatment with drugs.

Study authors conclude that screening all children for cholesterol, rather than just those with a family history, will identify more children with abnormal cholesterol levels and prevent premature cardiac events.

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