Every child in Britain should have their cholesterol level tested at 15 months – to protect their parents.
The radical plan would be the most effective way to prevent heart disease in later life among families at highest risk, doctors said. But it would leave a Sword of Damocles hanging over those children found to have high cholesterol who would not start treatment until they were in their 20s.
The proposal for a new screening test to target two generations simultaneously has been put forward by researchers from Barts and the London Queen Mary's School of Medicine.
High cholesterol is widely thought to be a problem of middle age, the legacy of a lifetime spent eating large helpings of fatty food. But those at highest risk suffer from an inherited condition which drives up their cholesterol levels independently of diet.
The genetic defect, called familial hypercholesterolaemia, affects two in every 1,000 people, amounting to about 120,000 in Britain. People with the defect aged 20 to 39 have a 100-fold increased risk of dying from heart disease. This is not as scary as it sounds because the condition is treatable with cholesterol-lowering drugs, called statins. Heart disease is caused by the build up of fatty deposits on the artery walls which narrow and can be blocked by a blood clot triggering a heart attack. High levels of cholesterol increase the fatty deposits and the artery narrowing but by lowering them with drug treatment the process is slowed.
However most families affected by the genetic defect do not know that they are. The Barts researchers concluded the best way of identifying affected parents was through their children.
They found screening was most accurate if done in early childhood – between the ages of one and nine – when a simple blood test detected 88 per cent of those affected. Screening newborns and young adults was much less effective.