Cholesterol screening and family history of vascular disease.
Hypercholesterolaemia is a major risk factor for the development of coronary heart disease (CHD). Early detection and management of hypercholesterolaemia could retard the atherosclerotic process. Given that CHD and hypercholesterolaemia cluster within families, a screening strategy based on a family history of vascular disease has been advocated. Serum total cholesterol concentrations were measured in a random stratified sample of 1012 children aged from 12-15 years old participating in a coronary risk factor surveillance study in Northern Ireland. Information about vascular disease in close family members was obtained by means of a questionnaire. The study population was divided into two groups according to total cholesterol values: (i) normal, < 5.2 mmol/l (n = 822) and (ii) raised, > or = 5.2 mmol/l (n = 190). A family history identified 63 out of 190 individuals with hypercholesterolaemia yielding a sensitivity of 33.2% and specificity of 71.5%. Our data indicated that a strategy whereby only children from high risk families are screened for hypercholesterolaemia is ineffective. While primary prevention emphasising a healthy diet for all is essential, the role of universal screening deserves further appraisal.
Department of Child Health, Institute of Clinical Science, Royal Victoria Hospital, Belfast.
E D
ED
Primrose
J M
JM
Savage
C A
CA
Boreham
G W
GW
Cran
J J
JJ
Strain
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000235:genetics / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011897:Random Allocation; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014652:Vascular Diseases / Q000235:genetics*
D002784:Cholesterol