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 choleste rol screening of prepubertal schoolchildren is effective in identifying chi ldren and their parents at risk of developing premature coronary heart dise ase (CHD) in a high-risk rural population. Methods. Seven hundred nine fifth-grade schoolchildren from seven rural App alachian counties participated in a school-based cholesterol screening prog ram. Family history of premature CHD, anthropometric and blood pressure mea surement, tobacco smoke exposure, dietary history, and physical activity le vels were collected. Results. One-fourth (114) of the children were "presumptively" dyslipidemic upon measurement of non-fasting finger-stick blood cholesterol (FSC). Subs equent fasting lipid profile obtained for 63 of these children and 79 of th eir parents confirmed the presence of dyslipidemia in 37 children (59%) and 52 parents (66%). Among confirmed dyslipidemic children, family history wa s not a good predictor of dyslipidemia (sensitivity 21.6%). FSC levels were significantly correlated with fasting total cholesterol of children and th eir parents. Conclusions. Universal nonfasting FSC screening of prepubertal schoolchildr en is effective in identifying dyslipidemic children and their parents, whe reas family history has low sensitivity in predicting children with elevate d blood cholesterol concentrations. (C) 2001 American Health Foundation and Academic Press.