At what age should lipid testing be done to identify severe hypercholesterolemia?
Lipid testing should be done beginning at age 2 years if a family history is suggestive of either early CVD or significant primary hypercholesterolemia. Moreover, children and adolescents with LDL-C 160 mg/dL (4.1 mmol/L) and a family history of early atherosclerosis or similarly elevated cholesterol in 1 parent likely are those with FH and related genetic disorders associated with accelerated atherosclerosis. Subclinical atherosclerosis data suggest divergence between affected and unaffected children and adolescents beginning at age 10 years, which supports screening by this age, although this topic is still considered controversial.