Although cholesterol tests are becoming a routine part of pediatric care, a new study has shown that the tests may be useless in predicting which children are at high risk for heart disease.
Many pediatricians have assumed that they are helping families by testing all children to identify those with high levels of cholesterol.
By monitoring children with excess cholesterol in their blood and helping them cut fats out of their diets, these doctors feel they are giving the children a head start on preventing heart disease later in life.
The new study throws that assumption into question. Some pediatricians and heart disease experts say the new findings, published today in the Journal of the American Medical Association, are evidence that the nation has become overly concerned about cholesterol levels in children.
The study involved 2,377 Iowa schoolchildren whose cholesterol levels were measured on several occasions and who were later tested as adults.
The investigators found that most of those who had high cholesterol levels in childhood had normal cholesterol levels as adults, even if they made no changes in their diets or way of life.
Dr. Ronald M. Lauer, a pediatrician at the University of Iowa who directed the research, and his colleague, Dr. William R. Clarke, a statistician, examined children whose cholesterol levels were above those of 75 percent of those tested on two occasions. When those children grew up, 75 percent of the girls and 56 percent of the boys no longer had high cholesterol levels.
The investigators also looked at children whose cholesterol levels were at or above 90 percent of the group on two separate occasions. As adults, 57 percent of those girls and 30 percent of those boys did not have high cholesterol levels.
Dr. Lauer emphasized, however, that he thought all families should follow a low-fat diet, which would lower the nation's cholesterol levels.
The paper was part of an issue of the journal largely devoted to cholesterol. One of the other studies published in it says that women who lowered their cholesterol levels had a regression of artery-clogging plaques, a finding that had previously been shown only for men. Another study compared the prices of cholesterol-lowering drugs and concluded that one of the oldest drugs, niacin, is the most cost-effective.