Keeping Track of Cholesterol: Children, Smoking and Pregnancy

Dr. Kang Health Pro
  • 1. When should children begin to check their cholesterol?

    Routine cholesterol screening is not recommended until one reaches the age of 20yrs. This is the age when the development of coronary artery disease begins to rise. Autopsies studies have shown that ~2% of men and ~0% of women age 15-19 have significant coronary artery disease. This % increases to 20% of men and 8% of women when age 30-34 with the highest incidence of significant disease found in people over the age of 65. The average age of men presenting with their first heart attack is 60 and for women 70 yrs of age. Screening for cholesterol abnormalities before age 20 may be appropriate in those people whose families are known to have some form of familial/inheritable lipid disorder, especially if they have other risk factors for heart disease, such as diabetes or hypertension.
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    2. How does smoking affect my cholesterol?

    Smoking adversely affects cholesterol levels, although the exact mechanism in not entirely clear. When compared to non-smokers, smokers have significantly higher serum concentrations of total cholesterol (3.0%), triglycerides (9.1%), very low density lipoprotein cholesterol aka. bad cholesterol (10.4%), and low density lipoprotein cholesterol aka. bad cholesterol (1.7%) and lower serum concentrations of high density lipoprotein cholesterol aka. good cholesterol (-5.7%). There is a direct dose response with smoking and cholesterol levels with heavy smokers having the worst overall cholesterol profiles. Smokers on average have an excess risk of ~70% in the development of coronary artery disease due to multiple deleterious mechanisms. It is estimated that the changes in the cholesterol profile from smoking may be responsible for ~9% of this excess risk.

    3. How will high cholesterol affect my pregnancy?

    When a person with high cholesterol becomes pregnant, 2 issues must be addressed: the risk to the mother and the risk to the fetus. With respect to the mother, pregnancy is well-known to dramatically increase cholesterol and triglyceride levels 300-500%. This is a normal adaptive response to pregnancy as an ample of supply of cholesterol and triglycerides are needed to maintain maternal function and fetal development. These levels usually fall back to pre-pregnancy several months after birth. It is unknown if there is an increased risk of heart disease with high cholesterol and triglyceride levels during pregnancy throughout the remainder of maternal life. There is no well established relationship between high cholesterol levels during pregnancy with the development of miscarriage or other conditions such as gallstones. With regards to the fetus, higher levels of cholesterol have been shown to be associated with a greater development of fatty streaks in the fetal blood vessels. These fatty streaks often regress after birth. It is unknown if these fatty streaks translate into a greater risk of heart disease as the child grows.

    Learn more about cholesterol.

Published On: June 16, 2006