Implications of childhood hypercholesterolemia
Richard E. Garcia, MDAddress reprint requests to R.E.G., Department of Primary Care, The Cleveland Clinic Foundation, One Clinic Center, 9500 Euclid Avenue, Cleveland, Ohio 44195.
Douglas S. Moodie, MD
Several studies have documented that hypercholesterolemia is common in American children. Other studies have shown that elevated cholesterol levels in childhood remain elevated well into adult life. Autopsy studies of adolescents have also found a strong positive correlation between antemortem cholesterol levels and early atherosclerotic changes in their aortas and coronary arteries. Collectively, these studies provide strong and consistent evidence that atherosclerosis begins in childhood. The evidence is also overwhelming that lowering elevated low density lipoprotein cholesterol levels reduces the risk of heart attacks caused by coronary heart disease, at least among middle-aged men. As a result, routine cholesterol and coronary heart disease risk factor surveillance in childhood is both productive and appropriate. Premature coronary heart disease may be largely preventable and atherosclerosis, if not preventable, can be significantly delayed.