As more children are diagnosed with diabetes, high blood pressure and heart disease, experts are recommending cholesterol checks for young adults and even toddlers.

“There are kids in elementary school that are on medication for heart disease, diabetes and high blood pressure,” said Lynn A. Maarouf, a nutrition expert with the University of Texas Medical Branch. “Basically, it’s a parental issue when kids are overweight.”

About one in six adults in the United States have high blood cholesterol, a waxy, fatlike substance necessary for good health. Too much cholesterol, however, collects on arterial walls, leading to disease and stroke, according to the Centers for Disease Control and Prevention.

Although there are no symptoms of high cholesterol, determining your risk is as simple as a blood test.

“Having an elevated cholesterol level is a major risk factor for developing heart attack, stroke and cardiovascular disease,” said Dr. Nicola Abate, a professor and chief of the Division of Endocrinology at the Medical Branch in Galveston.

“Cardiovascular disease is still the number one cause of disability in the country, and it’s almost completely preventable,” Abate said.

Risk Factors

Risk factors depend on your health and family illness history, said Dr. Tricia Elliott, an associate professor and family medicine physician at the medical branch.

Those with close relatives with a high body mass index — a measure of body fat based on height and weight — diabetes or who have had a heart attack or heart disease are at risk. Childhood obesity is another risk factor, which would necessitate cholesterol screening, Elliott said.

When considering treatment options, it helps to talk with a doctor about your cholesterol numbers compared to your risk factors.

Results from cholesterol screening will state a number associated with low-density lipoprotein, commonly called LDL or bad cholesterol.

Those with high-risk factors should have an LDL number less than 100, Abate said. Those with an intermediate risk factor should have numbers less than 130 and those with low risk should have an LDL below 160, Abate said.

Abate recommended testing for toddlers as young as 2 years old depending on risk factors or otherwise at the age of 18.


Doctors commonly prescribe statin drugs to lower cholesterol levels, but there are non-statin options available, such as ezetimibe, niacin, Questran and Welchol, Abate said.

“The advantage of ezetimibe is that it is usually easy to tolerate but it is not as effective as it has not thus far been proven to lower risk for heart attacks,” Abate said.

Niacin raises good cholesterol, known as high-density lipoprotein, and lowers bad cholesterol, but it comes with side effects, such as hot flashes or itching, Abate said.

Questran and Welchol don’t cause muscle aches, which are frequently seen with statins, Abate said. They also lower glucose and bad cholesterol but could cause bloating and constipation. Their effectiveness is lower than statins and could raise triglycerides, Abate said.

Red yeast rice contains statins in the product’s natural form, but it is less predictable at lowering cholesterol, Abate said. Red yeast rice is insufficient if patients require a large, 40 percent to 50 percent, reduction, Abate said.

Diet and exercise also play a major role in heart disease, but even the best diet and exercise programs lower bad cholesterol about 10 percent, Abate said.

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