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Population screening for hypercholesterolaemia in children is currently not recommended in Australia. Case finding by family tracing is an effective strategy for identifying most children with familial hypercholesterolaemia. Screening should be based on:
- a family history of familial hypercholesterolaemia or
- premature cardiovascular disease (before 55 years in men, before 60 years in women)
Children should be tested before the age of 10 years but usually not before the age of two years. The age chosen should take into account the onset of coronary artery disease within the family and the wishes of the parents.
Blood samples: non-fasting capillary or venous samples can be used for screening measurement of total cholesterol. If the concentration is above 5.5 mmol/L, which is the 95th centile in childhood, a fasting venous blood sample should be taken for measurement of total and high-density lipoprotein HDL cholesterol and triglyceride. The low density lipoprotein LDL cholesterol can then be calculated.