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Under 20 years old:
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 to be screened 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.
20 years and older:
Widespread population screening is not currently recommended in Australia. The Australian guidelines recommend targeting those most at risk, i.e. those most likely to benefit from intervention. This is determined by the presence of known risk factors, such as smoking, high blood pressure, diabetes, chronic kidney disease, familial hypercholesterolaemia, obesity/overweight, a family history of early heart disease, aboriginal or Torres Strait islander ethnicity.
Assessment is best done by a lipid profile, a blood test conducted after a 9 to 12 hour fast, which determines your total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels.