Cholesterol screening and family history of vascular disease.

Cholesterol screening for children is recommended currently only for those with a family history of premature coronary heart disease or hyperlipidemia. The authors report on a pediatric-office-based cholesterol screening program where the predictive values of family history indicators were evaluated along with reported television viewing, physical activity, and dietary habits in 1081 children (aged 2 to 20 years, mean 7.4 ± 3.6 [SD] years). Eight percent of these children had a total cholesterol value of 200 mg/dL or higher; 53% of such children reported watching 2 or more hours of television daily compared with 34% of children with lower cholesterol levels. Multivariate analyses revealed that excessive television viewing was the strongest predictor for a child to have a cholesterol value of 200 mg/dL or higher, with relative risks of 2.2 for 2 to 4 hours of television viewing per day (P < .01) and 4.8 for children watching more than 4 hours/day, when compared to those watching less than 2 hours/day (P < .01). In contrast, a positive family history of a high cholesterol level was only modestly associated with an increased probability of having a high cholesterol level (relative risk 1.6, P < .05), and a history of premature myocardial infarction in a parent or grandparent was not associated with a child's cholesterol level. Excessive television viewing was found to be associated with certain dietary and physical activity habits and may prove to be a useful, global marker for several life-style factors predisposing children to hypercholesterolemia.

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Early Carotid Atherosclerosis and Family History of Vascular Disease

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/01.atv.0000051383.75507.60 ◽

2003 ◽

Vol 23 (2) ◽

pp. 302-306 ◽

Cited By ~ 34

Author(s):

Paula Jerrard-Dunne ◽

Hugh S. Markus ◽

Donata A. Steckel ◽

Alexandra Buehler ◽

Stefan von Kegler ◽

...

Keyword(s):

Family History ◽

Vascular Disease ◽

Carotid Atherosclerosis ◽

History Of

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Family History of Atherosclerotic Vascular Disease Is Associated With the Presence of Abdominal Aortic Aneurysm

Journal of Vascular Surgery ◽

10.1016/j.jvs.2016.05.059 ◽

2016 ◽

Vol 64 (1) ◽

pp. 260

Author(s):

Z. Ye ◽

K.R. Bailey ◽

E. Austin

Keyword(s):

Abdominal Aortic Aneurysm ◽

Family History ◽

Aortic Aneurysm ◽

Vascular Disease ◽

Atherosclerotic Vascular Disease ◽

Abdominal Aortic ◽

History Of

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Cholesterol Screening?

PEDIATRICS ◽

10.1542/peds.85.6.1125 ◽

1990 ◽

Vol 85 (6) ◽

pp. 1125-1126

Author(s):

BARBARA A. DENNISON

Keyword(s):

Family History ◽

Ldl Cholesterol ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Screening Strategy ◽

The Third ◽

The Past ◽

Cholesterol Screening ◽

Premature Cardiovascular Disease ◽

History Of

To the Editor.— The paper by Drs Garcia and Moodie is the third article in the past 4 months to question the efficacy of family history as the first step in a screening strategy to identify children with hypercholesterolemia.1-3 Their finding that 50% of the children they identified with elevated low-density lipoprotein (LDL) cholesterol did not have a family history of premature cardiovascular disease or hyperlipidemia is essentially the same as that of Griffen and colleagues.2

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Cholesterol Screening in Children and Family History of Coronary Heart Disease.

Circulation ◽

10.1161/circ.103.suppl_1.9998-94 ◽

2001 ◽

Vol 103 (suppl_1) ◽

pp. 1369-1369

Author(s):

Viktorina N Muratova ◽

Syed S Islam ◽

Emily C Spangler ◽

Ellen W Demerath ◽

William A Neal

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Family History ◽

Lipid Profile ◽

School Children ◽

Preventive Health Care ◽

Blood Cholesterol ◽

Cholesterol Screening ◽

Cholesterol Levels ◽

History Of

P94 Background: Selective blood cholesterol screening of children based upon National Cholesterol Education Program (NCEP) guidelines of family history of premature cardiovascular disease (CVD) or parental hypercholesterolemia is inadequate in a population with high prevalence of coronary heart disease (CHD), low levels of cholesterol screening, low socio-economic status (SES) and diminished access to preventive health care. We hypothesize that universal cholesterol screening of pre-pubertal school children may be effective in identifying children and their parents with abnormal lipid levels in this high risk rural population. Fifth grade school children from seven rural Appalachian counties participated in a school based cholesterol screening program. Data on family history of premature CHD, anthropometric and blood pressure measurements, tobacco smoke exposure, dietary history and physical activity levels were collected at the time of screening. Seven hundred and nine 5 th grade students ( mean age 10.8 years) participated in the program. One hundred seventy four (24.5%) were considered presumptively dyslipidemic after non-fasting finger- stick (FS) cholesterol screening. Thirty six percent of these dyslipidemic children had a fasting lipid profile done. Dyslipidemia was confirmed in 37(59%) of these children. FS cholesterol levels were significantly correlated with fasting TC (r=0.80 p < 0.0001). Among confirmed dyslipidemic children, family history was not a good predictor of dyslipidemia (sensitivity 21.6%). Seventy nine parents of dyslipidemic children participated in fasting lipid profile assessment. Fifty two parents (67%) were dyslipidemic, most of them (79%) did not have a family history of premature CHD or hypercholesterolemia. FS cholesterol levels were also correlated with fasting TC of fathers (r=0.46 p=0.01), and mothers (r=0.32 p=0.02). Conclusion: Significant correlation exists between non-fasting FS cholesterol levels of children and subsequent fasting lipid profile of children and their parents. Family history has low sensitivity in predicting children with elevated serum cholesterol concentrations.

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Parental Knowledge and Attitudes About Universal Lipid Screening Among Children Aged 9 to 11 Years

Clinical Pediatrics ◽

10.1177/0009922820903043 ◽

2020 ◽

Vol 59 (4-5) ◽

pp. 439-444

Author(s):

Leah Kern ◽

Lisa Eichberger ◽

Helen Wang ◽

Tuo Lin ◽

Kyung E. Rhee

Keyword(s):

Family History ◽

Parental Knowledge ◽

Graduate Degree ◽

College Graduate ◽

Knowledge And Attitudes ◽

Cholesterol Screening ◽

Lipid Screening ◽

History Of ◽

Race Ethnicity ◽

Hispanic White

Nationally recommended universal lipid screening (ULS) in children aged 9 to 11 years is low. Little is known about parents’ understanding of screening. We conducted a survey exploring parental knowledge and attitudes regarding ULS. Of 91 parent respondents, 81.3% were female, 69.2% were non-Hispanic white, 90.1% had a college/graduate degree, and 63.7% had a family history of abnormal cholesterol. Overall, 45.5% agreed that ULS should be done for all children, 30.8% disagreed, and 23.1% were unsure. Parents’ support for ULS was significantly associated with their attitudes toward screening rather than their knowledge about cholesterol, family history of cardiovascular disease or abnormal cholesterol, age, race/ethnicity, or gender. Parents were less likely to agree that ULS should be done if they thought that cholesterol screening should be done based on a child’s health or family history rather than for all children ( P < .001), or if they thought that cholesterol screening was unnecessary ( P < .001).

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Family history of atherosclerotic vascular disease is associated with the presence of abdominal aortic aneurysm

Vascular Medicine ◽

10.1177/1358863x15611758 ◽

2015 ◽

Vol 21 (1) ◽

pp. 41-46 ◽

Cited By ~ 2

Author(s):

Zi Ye ◽

Kent R Bailey ◽

Erin Austin ◽

Iftikhar J Kullo

Keyword(s):

Abdominal Aortic Aneurysm ◽

Family History ◽

Aortic Aneurysm ◽

Vascular Disease ◽

Atherosclerotic Vascular Disease ◽

Abdominal Aortic ◽

History Of

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The advisability of implementing cholesterol screening in school-age children and adolescents with a family history of cardiovascular disease and hyperlipidaemia

Family Practice ◽

10.1093/fampra/16.5.501 ◽

1999 ◽

Vol 16 (5) ◽

pp. 501-505 ◽

Cited By ~ 4

Author(s):

C.-S. Liu

Keyword(s):

Cardiovascular Disease ◽

Family History ◽

Children And Adolescents ◽

School Age Children ◽

School Age ◽

Cholesterol Screening ◽

History Of

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Abstract 109: Manipulative Dexterity is Associated with Occult White Matter Ischemic Lesions in Healthy Asymptomatic Persons at Increased Risk for Cardiovascular Disease

Stroke ◽

10.1161/str.45.suppl_1.109 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Paul A Nyquist ◽

Lisa R Yanek ◽

Murat Bilgel ◽

Jennifer L Cuzzocreo ◽

Lewis C Becker ◽

...

Keyword(s):

White Matter ◽

Family History ◽

Cerebrovascular Disease ◽

Vascular Disease ◽

Large Population ◽

Manual Dexterity ◽

Excess Risk ◽

Small Vessel ◽

Visual Spatial ◽

History Of

Introduction: Persons with a family history of early-onset coronary artery disease (CAD) have an excess risk of stroke and CAD. White matter lesions (WML) on MRI represent small vessel ischemic cerebrovascular disease and are associated with incident stroke and neurocognitive decline with age. We hypothesized manipulative manual dexterity, an integration of fine motor, visual spatial, and cognition function, may be affected by increased WML burden in task-relevant brain regions across age ranges in persons at risk for pre-clinical occult vascular disease. We tested this in a large population with a family history of early CAD. Methods: Healthy 29-74 year old subjects (N=714; mean age 51± 11 years; mean education 14 ± 3 years; 42% male, 38% Black) were identified from probands with CAD <60 years. WML location and volumes were measured on 3T FLAIR MRI. Manipulative manual dexterity was measured with standardized timed grooved pegboard test. Left and right pegboard scores were averaged. Results: WML were observed in all age groups; mean overall pegboard scores were 108±18, and were within reference norms. In unadjusted analysis, pegboard scores were highly correlated in the expected direction with total WML volumes, r=0.34, p=<.0001; subcortical volumes r=0.30, <.0001 periventricular volumes r=0.31, <.0001; and with most regional WML volumes; frontal 0.34, <.0001; insula r=0.31, p<.0001, parietal r=0.31, p<.0001, and temporal volumes r=0.17, p <.0001. In separate multivariate regression analyses predicting (log) pegboard score adjusted for age, sex, race, education and nonindependence of families (GEE), total WML volume became more statistically significant ( p=5.79E-05) while other regions retained statistical significance, p< 0.01. Conclusions: Our findings in a large population-based sample with a family history of early CAD confirm that greater WML volumes in multiple brain locations are associated with higher pegboard scores (worse performance) independent of age, sex, race, and education. This suggests that small vessel cerebrovascular disease is present in an early preclinical state and that WML volumes impact manipulative manual dexterity in healthy middle-aged and younger individuals with excess risk for clinical vascular disease.

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