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Cholesterol Screening of Children

Wendy L. Stuhldreher, PhD, RD; Trevor J. Orchard, MBBCh, MMedSci; Richard P. Donahue, PhD; Allan L. Drash, MD
JAMA. 1991;265(24):3247. doi:10.1001/jama.1991.03460240042019.
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To- the Editor.—  The reports from Lauer and Clarke1 and Newman et al2 add valuable data to the issue of childhood screening for hypercholesterolemia. Unfortunately, they continue to miscast this issue in terms of general childhood screening vs screening only "high-risk" children and ignore important changes that occur between childhood screening and adulthood.Few should disagree with the necessity of identifying and treating children with familial hypercholesterolemia due to the well-known risks of premature coronary heart disease. The heterozygous form (prevalence of 1:200 to 1:500) is a common and serious condition associated with a male mortality rate of 25% and a morbidity of 50% by age 50 years.3 Universal screening of children is surely justified for this condition alone. Furthermore, there is little doubt that atherosclerosis begins in childhood.44Our follow-up study5 of a populationbased cohort of children aged 11 through 14 years and followed


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