Screening all babies for high cholesterol could save many lives

Doctors in the UK say in order to reduce the number of people suffering from heart disease children as young as 15 months should be screened for high cholesterol.

The doctors say a national screening programme involving a blood test for all babies, at the same time as routine vaccinations such as MMR are carried out, could help to slash the number of people in the UK with heart disease caused by hereditary high cholesterol.

According to the doctors about two in every 1,000 people are affected by familial hypercholesterolaemia, which carries a high risk of a build-up of cholesterol in the blood and premature death from heart disease.

Exactly who in the general population has the genetic disorder is difficult to ascertain.

David Wald, a consultant cardiologist and senior lecturer at the Wolfson institute of preventive medicine at the University of London, and colleagues carried out a study to find out the best way to screen for the disorder.

The team reviewed 13 studies involving a total of 1,907 people with hereditary high cholesterol and 16,221 without.

They found that screening was most effective in children aged between one and nine as it identified 88% of those with the genetic defect in that age group, but was much less successful in newborns and in young adults.

The idea is not to treat the child, but to identify the parent with a problem and put them on cholesterol-lowering drugs.

They say by identifying affected children an opportunity is provided to identify affected parents and the screening accomplishes two aims simultaneously: screening children and screening their parents.

They suggest treatment to lower cholesterol could be initiated immediately in the parent and delayed in the child until adulthood.

The researchers say in most families, only one parent would be affected by the disorder but doctors would test the cholesterol levels of both.

The one with higher cholesterol would most probably be the carrier and would then be treated.

People with a family history of the condition have a high risk of dying from coronary heart disease - 20 to 39-year-olds have a risk that is 100 times more than that of people who do not have the condition.

However, taking statins lowers the danger substantially.

DNA tests would establish who is affected but are more complicated and more expensive and would miss 20% of affected parents who have a chromosomal mutation that cannot yet be picked up.

The researchers say screening without DNA diagnosis has the advantage of being simpler and less expensive.

They believe the strategy has the potential to prevent a major cause of coronary heart disease in young adults.

The study is published in the British Medical Journal.

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