Can we detect children at risk for coronary disease?

Focusing upon screening for hyperlipidemia in childhood, Holtzman1 recently concluded "...at this juncture we do not know how to detect most children at risk for coronary disease, and even if we did, we would not know what to do when we found them." Holtzman's conclusions, however, seem to be incongruent with multiple, extensive, population-based studies of coronary heart disese (CHD) risk factors in children.

One hundred twenty-nine years ago, Semmelweis2 summarized his data relative to etiologies of puerperal fever, and suggested preventive medical approaches, much to the derision of his contemporaries.

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