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June 26, 1991

Cholesterol Screening of Children

Author Affiliations

University of California, San Diego School of Medicine La Jolla

University of California, San Diego School of Medicine La Jolla

JAMA. 1991;265(24):3246-3247. doi:10.1001/jama.1991.03460240042018

To the Editor.—  The December 19, 1990, issue of JAMA is of special interest to the students of pediatric preventive cardiology. Lauer and Clarke1 present data from the Muscatine Study and demonstrate imperfect tracing of serum cholesterol levels from childhood to adulthood, arguing against universal screening of children. A Special Communication by Newman et al2 eloquently presents their views against childhood cholesterol screening. While the debate reflects the good health of pediatric preventive cardiology, it seems to overshadow the concept of modest and proven harmless life-style changes in children. The need to affect lower cholesterol distribution in all children is justified since the entire adult cholesterol distribution in the United States is high and the majority of heart attack victims are in low- to moderate-risk groups.The Muscatine values are each based on single determinations. A recent study3 shows that the within-person fluctuations of serum lipoprotein levels