This year the Expert Panel of the US National Cholesterol Education Program published recommendations on blood cholesterol levels in children and adolescents. The guidelines do not recommend universal cholesterol screening for all children, but target potential high-risk subjects. There is, however, significant opposition to the proposed attempts to detect and treat pediatric hyperlipidemia. The debate, predominantly by epidemiological scientists, centers on the safety and cost-effectiveness of primary prevention of atherosclerosis by lipid reduction, especially at an early age. Despite the controversy, an extensive survey of physician practices regarding the detection and treatment of hyperlipidemia in children indicates that a significant number of physicians have already implemented universal screening and drug therapy.
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