Family History of Coronary Artery Disease and Cholesterol: Screening Children in a Disadvantaged Inner-City Population.

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The mean TSC level was 4.27 mmol/L (SD +-/0.85) (165.0 mg/dL (SD +-/32.8)). The 29.4% of this population with a history suggestive of high risk for hypercholesterolemia had a mean TSC of 4.48 mmol/L (SD +-/0.971) (173.2 mg/dL (SD +-/37.5)), and those with no risk history had a mean TSC of 4.18 mmol/L (SD +-/0.750) (161.4 mg/dL (SD +-/29.9)) (P < .005). Use of family history of coronary artery disease as a screening tool had a sensitivity of 39.3%, a specificity of 74.5%, and a positive predictive value of 39.8% for detection of moderate hypercholesterolemia (TSC >= 4.66 mmol/L (180 mg/dL)).


This population's mean TSC level did not differ (P > .10) from those obtained in multiple large studies of average North American populations, and the predictive value and sensitivity of family history as a screening tool was comparable, although the prevalence of a positive family history was greater. The findings may be due to a greater prevalence of coronary artery disease at a young age in these families. In this population, a positive risk history is an important indicator for further evaluation of these children. Pediatrics 1994;93:109-113; coronary artery disease, family history, screening, cholesterol, inner city, socioeconomic status.

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