What if a blood test could reveal that your child is at high risk for early heart disease years in the future, giving you a chance to prevent it now? A big study in England did that — screening thousands of babies for inherited risk — and found it was twice as common as has been thought. 
 
 The study also revealed parents who had the condition but didn't know it, and had passed it on to their children. Ninety percent of them started taking preventive medicines after finding out. 
 
 Researchers say the two-generation benefits may convince more parents to agree to cholesterol testing for their kids. An expert panel in the United States recommends this test between the ages of 9 and 11, but many aren't tested now unless they are obese or have other heart risk factors such as diabetes or high blood pressure. 
 
 For every 1,000 people screened in the study , four children and four parents were identified as being at risk for early heart disease. That's nearly twice as many as most studies in the past have suggested. 
 
 "We really need to pay attention to this," said Dr. Elaine Urbina, director of preventive cardiology at Cincinnati Children's Hospital Medical Center and a member of the U.S. expert panel. "It's reasonable to screen for something that's common, dangerous and has a treatment that's effective and safe." 
 
 Dr. William Cooper, a pediatrics and preventive medicine professor at Vanderbilt University, called it "an innovative approach" that finds not just kids at risk but also parents while they're still young enough to benefit from preventive treatment, such as cholesterol-lowering statin drugs. 
 
 Statins aren't recommended until around age 10, but certain dietary supplements such as plant sterols and stanols could help younger kids, Urbina said. 
 
 "We're not talking about putting all these kids on statins," she said. 
 
 The study was led by Dr. David Wald at Queen Mary University of London. He and another author founded a company that makes a combination pill to prevent heart disease. The work was funded by the Medical Research Council, the British government's health research agency. Results were published Wednesday by the New England Journal of Medicine. 
 
 Researchers were testing for familial hypercholesterolemia, a genetic disorder that, untreated, raises the risk of a heart attack by age 40 tenfold. 
 
 They did a heel-stick blood test on 10,059 children ages 1 to 2 during routine immunization visits to check for high cholesterol and 48 gene mutations that can cause the disorder. If a child was found with the disorder, parents were tested. 
 
 One in 270 children had the gene mutations; others were identified through cholesterol levels alone. 
 
 "That's a pretty common genetic defect," said Dr. Stephen Daniels, chairman of pediatrics at the University of Colorado School of Medicine and a member of the U.S. expert panel. 
 
 But many parents balk at the idea of testing children for a disorder associated with middle age, experts say. 
 
 Karen Teber, a media relations specialist in Madison, Wisconsin, was surprised when a doctor wanted to test her 12-year-old stepson. "My reluctance was really born out of lack of information," she said. "I hadn't heard of it before." 
 
 The study did not address whether screening is cost-effective. In the U.S., cholesterol tests cost around $80 and usually are covered by health insurance, though much lower prices often are negotiated. The study authors in England estimated that if cholesterol testing costs $7 and gene testing costs $300, it would cost $2,900 for every person identified as having the disorder. 
 
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 Online: 
 
 U.S. guidelines: http://www.nhlbi.nih.gov/guidelines/cvd_ped/index.htm 
 
 Cholesterol info: http://tinyurl.com/23dtxvo 
 
 and http://www.nhlbi.nih.gov/health/resources/heart#cholesterol 
 
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 Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP . 

 Screening strategy could prevent about 600 heart attacks in people under the age of 40 
 
 The researchers from QMUL's Wolfson Institute of Preventive Medicine estimate that, with effective treatment, the screening strategy could prevent about 600 heart attacks in people under the age of 40, each year in England and Wales, if the programme was rolled out by public health agencies. 
 
 Familial hypercholesterolaemia (FH) is a genetic disorder characterised by high cholesterol levels and is the main inherited cause of early heart disease. Without preventive medication young FH adults have about a 10-fold increased risk of a heart attack before the age of 40. 
 
 In the largest study to date of cholesterol and FH mutations in children, the prevalence of FH mutations in children was found to be about 1 in 270, nearly double that previously reported (1 in 500). 
 
 Because of the inherited nature of the disorder every child identified with the disorder will have one parent also affected. This offers the opportunity of screening two generations at the same time - so-called child-parent screening. 
 
 Lead researcher Professor David Wald said: "This is the first demonstration that child-parent screening works on a large scale. It's the only screening method that stands a reasonable chance of covering the whole population and identifying those at highest risk of an early heart attack. 
 
 "Now that we've demonstrated this as being effective across England, the next step is for public health agencies to consider offering this routinely at the time of childhood vaccination to test all children aged 1-2 years." 
 
 The study, published in the New England Journal of Medicine and funded by the Medical Research Council, involved screening at 92 general practices across England. 10,059 children were tested for high cholesterol and FH genetic mutations and 40 were found to be FH positive. 
 
 Once an FH positive child was found, the parents were then contacted for screening, revealing an additional FH positive parent. Overall, one person at high risk of early heart attack was identified for every 125 people tested. 
 
 The child-parent screening strategy identifies children and their parents together so that early preventive action can be taken. Medication, including statins, can be started immediately in the parents and in children as teenagers, and advice can be given on sensible diets and avoidance of smoking. 
 
 Professor Wald added: "This is an example of an effective screening strategy being combined with routine vaccination, which has clear advantages. No extra clinic visits are needed and uptake is high because parents are already focussed on the future health of their children and the family as a whole. The one-stop service requires no new clinical infrastructure and is simple and inexpensive to implement." 
 
 The researchers say that GPs and parents welcomed the screening opportunity, with 84 per cent of families accepting it. 
 
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 Notes to the editor 
 
 Research paper: 'Child-Parent Familial Hypercholesterolemia Screening in Primary Care'. David S. Wald, F.R.C.P., Jonathan P. Bestwick, M.Sc., Joan K. Morris, Ph.D., Ken Whyte, Lucy Jenkins, F.R.C.Path., and Nicholas J. Wald, F.R.S. The New England Journal of Medicine 2016;375:1628-37. DOI: 10.1056/NEJMoa1602777 

 An ounce of screening now may prevent hundreds of early heart attacks in the UK down the road, suggests a new study published Thursday in the New England Journal of Medicine. 
 
 Researchers conducted a small-scale screening program across 92 doctors’ offices scattered throughout England. They were specifically looking for children with a rare genetic condition called familial hypercholesterolaemia (FH), which causes high levels of low density lipoprotein (LDL) cholesterol and dramatically increases the chances of a heart attack — many sufferers experience one in their 40s or earlier without treatment, and 85 percent of men with FH have had one by the time they turn 60. Over 10,000 children were tested for high cholesterol and the FH mutation while they got their routine childhood vaccines, and 32 FH positive children were identified. Since the mutation is passed down from one side of the family, doctors also screened these children’s parents, a strategy known as child-parent screening, or cascade testing, and found an extra 40 people with FH. 
 
 Ultimately, the researchers estimated that for every 125 people screened, the program had found one at high risk of having a heart attack before the age of 40. Expanded to the rest of the country, they calculated the program would prevent around 600 such heart attacks annually. 
 
 "This is the first demonstration that child-parent screening works on a large scale,” said lead author Professor David Wald of the Queen Mary University Of London in a statement. “It's the only screening method that stands a reasonable chance of covering the whole population and identifying those at highest risk of an early heart attack.” 
 
 A screening program for a rare genetic condition can reliably find people at high risk of early heart attacks, UK researchers find, and may prevent hundreds of cases annually if expanded further. Pixabay, Public Domain 
 
 Aside from being life-saving, the program could easily be implemented, explained Wald. 
 
 "This is an example of an effective screening strategy being combined with routine vaccination, which has clear advantages,” he said. “No extra clinic visits are needed and uptake is high because parents are already focussed on the future health of their children and the family as a whole.” 
 
 Overall, 84 percent of families asked went through with the screening. 
 
 FH screening programs have begun in countries elsewhere, such as the Netherlands and Slovenia. In the U.S., the Centers for Disease Control and Prevention has called for a rapid expansion of state and local efforts to test for FH and other common but rarely detected mutations, dubbing them “Tier 1 applications” for genetic screening. 
 
 Currently, however, only a few states (Texas, Utah, and West Virginia) have started any such programs. West Virginia has offered universal cholesterol screenings to 5th grade children since 1998, while Utah and Texas asked its high school students to fill out “family tree” surveys during the 1980s to find people with a high genetic risk of cancer and heart disease. West Virginia’s program has so far found more than 200 children and parents with the condition, out of 100,000 5th graders screened. 
 
 Earlier this August, the US Preventive Services Task Force, an independent panel of experts that guide nationwide screening practices, found these programs can lower the LDL levels of children with FH via preventative treatment. As of yet, though, there’s no concrete evidence whether these early efforts prevent later heart disease, they added. 
 
 It’s estimated that anywhere from one in every 200 to 500 people may have FH. 
 
 Source: Waid D, Bestwick J, Morris J, et al. Child-Parent Familial Hypercholesterolemia Screening in Primary Care. The New England Journal of Medicine. 2016.
– It's never too early for baby's first cholesterol test. Researchers believe all children between the ages of 1 and 2 should be screened for familial hypercholesterolemia (FH), a genetic condition that drastically increases the risk of heart attacks under the age of 40, according to a press release. In a study published Thursday, researchers screened more than 10,000 toddlers for FH through genetic and cholesterol testing. They found nearly 0.4% of children have FH—nearly twice as many as previously believed. Researchers say early testing could prevent about 600 heart attacks in people under the age of 40 every year in Britain alone. "It's reasonable to screen for something that's common, dangerous, and has a treatment that's effective and safe," one doctor tells the AP. Researchers argue that early screening would be easy to implement, Medical Daily reports. Toddlers can be tested at the same time they're vaccinated, and there's no follow-up visits required. According to AFP, the best treatment for children with FH is exercise and eating right. Testing toddlers also has another benefit. Because FH is passed on genetically, finding a child with FH also means finding at least one parent with the condition who may or may not have been aware of it. Researchers say 90% of parents who found out they had FH during the study sought treatment for it. And early testing is apparently popular with families. During the study, 84% of families asked if they wanted their child screened said yes. (A study found 45% of heart attacks may go unnoticed.)