Definition

High cholesterol is a higher than normal level of cholesterol in the blood. It is more common in adults but can occur in children.

There are 2 types of cholesterol that may have the most significant effect on cardiovascular disease. One is high density lipoproteins (HDL) or good cholesterol. High levels of HDL have been linked to a lower risk of heart disease. The second type is called low density lipoproteins (LDL) or bad cholesterol. High levels of LDL cholesterol can lead to blockages in the blood vessels. This can lead to heart attacks and strokes.

Heart Attack Blockages in the blood vessels can lead to heart attacks. Copyright © Nucleus Medical Media, Inc.

Causes

High cholesterol may be caused by a combination of factors, such as:

• Being prone to high cholesterol due to your genes
• Being overweight or obese
• A high-fat diet and low activity levels

Risk Factors

Risk factors include:

• Obesity
• Having a family history of high cholesterol or heart disease or stroke
• Having high blood pressure
• Smoking
• Having certain conditions, such as diabetes, kidney disease, and underactive thyroid
• Some medications, such as steroids, isotretinoin [acne medicine], beta-blockers, protease inhibitors, diuretics, and cyclosporin

Symptoms

High cholesterol does not usually cause any symptoms.

Diagnosis

Screening tests help doctors identify children who have high cholesterol. The screening recommendations are:

• 2-8 years old— no screening needed unless there are risk factors
• 9-11 years old—should be screened at least once
• 12-17 years old—no screening needed unless there are risk factors
• 17-21 years old—should be screened at least once

Screening is done by testing the lipid levels in the blood when your child is not fasting, for example:

• Total cholesterol (the total amount of cholesterol in the blood)
• HDL—good cholesterol
• LDL —bad cholesterol
• Triglycerides (a type of fat that can also help predict the risk of future heart disease)

Note: Normal cholesterol levels are different for children than for adults. The doctor will use different cut-off points for diagnosing high cholesterol in your child. If the values are high, they will be repeated when your child has been fasting.

In addition to the blood test, the doctor will:

• Ask about your child’s symptoms.
• Take your child’s medical history.
• Do a physical exam.

Treatment

Lifestyle changes are a very important part of treatment.

Prevention

For most children, high cholesterol can be prevented with healthy lifestyle habits such as:

• Eat a diet that is rich in fruits, vegetables, and whole grains.
• If your child is overweight, follow a safe weight loss program. Use a program recommended by your doctor or dietitian.
• Encourage your child to participate in physical activity on a regular basis.
• Talk to your child about the dangers of smoking.
• Be a good role model for your child. For example, eat healthy food and participate in physical activities as a family.