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This department is currently not accepting appointment requests online. Please call us at: 617-355-6000. International +1-617-355-6000.

This department is currently not accepting appointment requests online. Please call us at: 617-355-6000. International +1-617-355-6000.

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Locations
  • Heart Center at Boston Children's Hospital

    Today it's been 5 years since my son Matthew's A.V. Canal repair. I remember the nurses: Shannon, Jaime, and Patrick....They were so good with Matthew and with my husband and I.
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  • Heart Center at Boston Children's Hospital

    If it wasn't for Children's Hospital and the Cardiac wing he wouldn't be here. Thank you all for what you have done for us and giving him a chance to grow in front of our eyes! Thank you Dr. Mah, Dr. Baird, and Dr. de Ferranti we owe you the world.
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  • Heart Center at Boston Children's Hospital

    5 years ago today, I placed my one week old son in Dr. Emani's hands to repair his COA. I remember it like it was yesterday, and I'm thankful every day for the care we received at the Heart Center at Boston Children's Hospital.
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  • Heart Center at Boston Children's Hospital

    1 year ago today Dr Baird performed open heart surgery on Cayman. It did NOT slow him down. Today his heart is as good as new and he barely even has a scar. Thank you Dr Baird and everyone on the cardiac floor at Boston Children's Hospital.
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  • Heart Center at Boston Children's Hospital

    Two years ago today we were at Boston Children's Hospital and our daughter, Emily, was having an aortic stent placed. We were told it would have to be replaced by the time she turned 2 (which was last June) but its still in place and working beautifully. We thank God every day for the amazing work of Dr. Gerald Marx and Dr. James Lock.
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  • Heart Center at Boston Children's Hospital

    This weekend we celebrated our beautiful daughter, Mikayla's 1st birthday and that’s thanks to the amazing surgeons and staff on the 8th floor!! Mikayla was born with a rare diagnosis of Pentalogy of Cantrell which included several heart defects.
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Support Boston Children's Heart Center

Contact the Preventive Cardiology Clinic

Preventive Cardiology Clinic Lipid Screening

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Goals of the new guidelines

  • Identify familial hyperlipidemias (FH) associated with early cardiovascular disease, which are present in 1 in 300-500 children, but are asymptomatic until there is myocardial ischemia. Individuals with FH who are untreated have a risk of premature coronary heart disease 20 times greater than those without FH. (Of note, one study suggests the risk of cardiac events in FH can be reduced to that of the general adult population by statin therapy, but only if these lipid disorders are identified early.)

  • Diagnose non-genetic LDL lipid disorders that require lifestyle modification. NHANES data suggest 1 in 5 adolescents in the US has some type of lipid disorder (JAMA 2010, MMWR Morb Mortal Wkly Rep. 2010 Jan 22:59(2):29-33. Prevalence of abnormal lipid levels among youths. United States, 1999-2006. Centers for Disease Control and Prevention [CDC)].)

Screening guidelines

  • Screen all children once between the ages 9 and 11 years, and again once between 17 and 21 years.

  • Continue selective screening of high risk patients (family history of early CVD events or other CVD risk factors) starting at age 2 years.

  • Screen with a fasting lipid profile OR non-fasting TC and HDL to calculate non-HDL cholesterol levels.

Management guidelines

  • If non-fasting non-HDL cholesterol is ≥ 145 mg/dL, or HDL < 40 mg/dL, obtain fasting lipid profile.

  • Refer to specialist directly for LDL ≥ 250 mg/dL or fasting TG≥ 500 mg/dL.

  • Initial treatment for nearly all patients is 6 months of targeted lifestyle change.

  • Treat high TG differently from high LDL, both in terms of nutrition counseling and pharmacotherapy (guidelines include useful tables and algorithms to guide treatment).

  • Use lipid-lowering medications only in patients who have not responded to 6 months of lifestyle counseling and have LDL ≥190 mg/dL.

  • Use somewhat lower LDL cutpoints for patients with high-risk conditions using lower cutpoints.

  • Recommended age for pharmacotherapy is ≥ 10 years, except in very high risk cases.

  • sarah.deferranti@cardio.chboston.org
The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO
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