High cholesterol - children

Definition

Cholesterol is a fat (also called a lipid) that the body needs to work properly. There are many types of cholesterol. The ones talked about most are:

Too much bad cholesterol can increase the chance of getting heart disease, stroke, and other problems.

This article is about high cholesterol in children.

Alternative Names

Lipid disorders - children; Hyperlipoproteinemia - children; Hyperlipidemia - children; Dyslipidemia - children; Hypercholesterolemia - children

Causes

Most children with high cholesterol have one or more parent who has high cholesterol. The main causes of high cholesterol in children are:

Certain health conditions can also lead to a high cholesterol level, including:

Several disorders that are passed down through families lead to abnormal cholesterol and triglyceride levels. They include:

Exams and Tests

A cholesterol test is done to diagnose high blood cholesterol.

Guidelines from the National Heart, Lung, and Blood Institute recommend screening all children for high cholesterol:

However, not all expert groups recommend screening all children and instead focus on screening children at higher risk. Factors that increase a child's risk include:

General targets for children are:

If cholesterol results are abnormal, children may also have other tests such as:

Your child's health care provider also may ask about a medical or family history of:

Treatment

The best way to treat high cholesterol in children is with diet and exercise. If your child is overweight, losing excess weight may help treat high cholesterol. But you should not restrict your child's diet unless your child's provider recommends it. Instead, offer healthy foods and encourage physical activity.

DIET AND EXERCISE

Help your child make healthy food choices by following these guidelines:

Encourage your child to be physically active. Children ages 5 years and older should be active at least 1 hour a day. Other things you can do include:

Other steps include teaching children about the dangers of tobacco use.

DRUG THERAPY

Your child's provider may want your child to take medicine for cholesterol if lifestyle changes do not work. For this the child must:

Children with very high cholesterol may need to start these medicines earlier than age 10. Your child's provider will tell you if this may be needed.

There are several types of medicines to help lower blood cholesterol levels. The medicines work in different ways. Statins are one kind of medicine that lowers cholesterol and has been proven to reduce the chance of heart disease.

Outlook (Prognosis)

High cholesterol levels can lead to hardening of the arteries, also called atherosclerosis. This occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard structures called plaques.

Over time, these plaques can block the arteries and cause heart disease, stroke, and other symptoms or problems throughout the body.

Disorders that are passed down through families often lead to higher cholesterol levels that are harder to control.

References

Daniels SR, Couch SC. Lipid disorders in children and adolescents. In: Sperling MA, ed. Sperling Pediatric Endocrinology. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 25.

Kliegman RM, St. Geme JW, Blum NJ, et al. Defects in metabolism of lipids. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 106.

Park MK, Salamat M. Dyslipidemia and other cardiovascular risk factors. In: Park MK, Salamat M, eds. Park's Pediatric Cardiology for Practitioners. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 33.

Shustak RJ, Brothers JA, Daniels SR. Special patient populations: children and adolescents. In: Ballantyne CM, ed. Clinical Lipidology: A Companion to Braunwald's Heart Disease. 3rd ed. Philadelphia, PA: Elsevier; 2024:chap 33.

US Preventive Services Task Force; Barry MJ, Nicholson WK, Silverstein M, et al. Screening for lipid disorders in children and adolescents: US Preventive Services Task Force Recommendation Statement. JAMA. 2023;330(3):253-260. PMID: 37462699 pubmed.ncbi.nlm.nih.gov/37462699/.


Review Date: 7/31/2024
Reviewed By: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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