School-based blood cholesterol screening.

Coronary artery disease, the major cause of death in developed countries, begins early in childhood. Elevated blood cholesterol, a major risk for coronary artery disease in adults, has been associated at autopsy with atherosclerotic disease in children. To explore the feasibility of mass screening of blood cholesterol levels in children, a school-based screening and education program for fourth-graders was carried out in a Southern California school district. Approximately 10% of the children had blood cholesterol levels of 200 mg/dl or more, the upper limit of desirable levels for adults. These children and their parents returned for repeat cholesterol testing and nutrition counseling. A family history of early coronary artery disease was present in only one third of the children with high cholesterol levels; this fact, coupled with consumable costs less than $2 per child, suggests that cholesterol screening is a practical, cost-effective addition to school health programs.