Family history fails to detect the majority of children with high capillary blood total cholesterol.

To examine the predictive value of family history in detecting children with high blood cholesterol, finger-stick screening was done in 1,118 children ages 9-10 whose parents provided parental and grandparental history of cardiovascular disease events and risk factors. Mean blood total cholesterol was 167.7 mg/dl with no significant gender or ethnic differences. Of 157 children with blood cholesterol 200 mg/dl or greater, only 61 (38.9%) had a family history of early myocardial infarction or hyperlipidemia; however, the prevalence of a positive family history varied from 2.8% in Vietnamese-Americans to 38.5% in Spanish-surnamed students to 52.6% in all other children. Adherence to current policies recommending screening only children with a positive family history will result in failing to detect a majority of children whose blood cholesterol levels exceed desirable levels for adults, particularly those from ethnic families recently arrived in the U.S.