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To Your Health: NLM update Transcript

Cholesterol screening for kids?: 10/24/2016

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine (NLM).

Here is what's new this week in To Your Health - a consumer health oriented podcast from NLM - that helps you use MedlinePlus to follow up on weekly topics.

Some leading U.S. health organizations currently disagree about the need for children to be screened for cholesterol levels in their bloodstream, finds a recent article published in Science.

Science notes the extent of the disagreement recently was evidenced by negative reactions to the U.S. Preventive Services Task Force recommendation against screening 9-11 year olds for cholesterol levels.

MedlinePlus.gov explains some types of high cholesterol levels, especially LDL, can be a predictor of heart disease among adults. Statins are commonly prescribed to reduce LDL levels.

The U.S. Preventive Services Task Force makes independent recommendations about primary medical care. The Task Force's recommendations gained importance after the Affordable Care Act was implemented in 2014 because the Task Force's recommendations now set standards honored by Medicare and Medicaid, the two core sources of public health insurance in the U.S.

While autonomous in its judgments, the U.S. Preventive Services Task Force is convened and supported by the Agency for Healthcare Research and Quality within the U.S. Department of Health and Human Services. Since NLM's podcasts began, we have followed the U.S. Preventive Services Task Force's activities with interest!

Science reports the Task Force's recommendations to avoid screening for LDL (or cholesterol) in children are based on mixed findings about the impact of taking statins. While 13 statin trials of children suggest they reduce LDL levels, Science reports additional research counters children with untreated, high LDL levels have normal LDL as adults.

In addition, Science reports there is a dearth of research about a key issue: the long-term effects on children who take statins and continue to do so as adults.

Conversely, Science reports the National Heart, Lung, and Blood Institute (NHLBI - within NIH) has recommended that children with high LDL take statins. Moreover, NHLBI's recommendations have been endorsed by The American Academy of Pediatrics, a leading medical society of the physicians who care for children.

As Science reports (and we quote): 'The screening question braids together some of the toughest subjects in medicine, including how or whether to set guidelines with incomplete scientific evidence, and when to give drugs to treat a risk factor whose effects, if they manifest, are probably decades off' (end of quote).

Science notes all sides agree there is a need for more evidence -- especially research that over time compares kids with high LDL who opt for different treatment options. In the interim, Science notes it is voluntary for a physician to recommend a cholesterol test. Science notes a 2014 survey of 528 Minnesota primary pediatric providers suggests about 16 percent screen their young patients.

Meanwhile, information about cholesterol and your child is available within the 'children' section of MedlinePlus.gov's cholesterol health topic page. The Nemours Foundation helps explain cholesterol levels to kids also within the 'children' section of MedlinePlus.gov's cholesterol health topic page.

Tailored information for teens about diet and cholesterol (from Children's Hospital Boston) is available in the 'teenagers' section of MedlinePlus.gov's cholesterol health topic page.

MedlinePlus.gov's cholesterol health topic page also provides links to the latest pertinent journal research articles, which are available in the 'journal articles' section. Links to relevant clinical trials that may be occurring in your area are available within the 'clinical trials' section. You can sign up to receive updates about cholesterol as they become available on MedlinePlus.gov.

To find MedlinePlus.gov's cholesterol health topic page, please type 'cholesterol' in the search box on MedlinePlus.gov's home page, then, click on 'cholesterol (National Library of Medicine).' MedlinePlus.gov also has health topic pages devoted to heart diseases. Helpful information about individual types and brands of statins is available within the 'drugs and supplements' section, which is located on the bar near the top of MedlinePlus.gov's home page.

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A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you. Please join us here next week and here's to your health!