Should kids be screened yearly? Some doctors believe so.
New studies show that tens of thousands of kids could be affected by high cholesterol and not even realize it.
The condition could lead to major health problems later in life.
Erin Peiffer had no idea she had heart disease.
Even though her cholesterol was high, doctors told her she wasn't at risk because she was young and in shape.
At the age of 39, during a water aerobics class, she had a heart attack and needed emergency surgery to clear a blockage in one of her arteries.
"After the surgery at Hopkins, they were obviously very interested because I was somewhat of an anomaly being relatively young for the severe onset and presentation, so they asked that my three children, who were 4, 6, and 9 at the time have blood work done to see how they were doing," she says.
Her two sons both had cholesterol levels above 300, more than double what's normal for a child.
While both boys are now on medication to lower their cholesterol, Peiffer says her sons would never have been tested if she didn't have her heart attack.
"Children are not routinely tested for cholesterol at the moment," explains pediatrician Dr. Peter Kwiterovich. "There are a few pediatric practices that do tests on all their children, but it's the exception rather than the rule at the moment."
New studies are encouraging universal screening for all children.
One report published this summer in the journal Pediatrics looked at 20,000 West Virginia fifth graders.
29 percent of those kids would never have been tested because they didn't have a family history of heart disease.
Of that group, ten percent had high cholesterol, some of them high enough to warrant medication.
Dr. Kwiterovich specializes in cholesterol research at Johns Hopkins Children's Center.
He says arteries can start building plaque at a young age, but there's evidence showing that early intervention can help people later in life.
"The most important treatment is modifying the diet for saturated fat, trans fat, and cholesterol, trying to help children be a more ideal weight, and exercise," Kwiterovich says.
The Peiffer family has taken that advice.
They take a cholesterol-lowering drug once a day and changed their diet.
There are some concerns about universal screening.
Medical experts say not enough doctors are trained to test for cholesterol in children.
Another big worry is that drug companies are pushing testing so they can sell more cholesterol-lowering drugs.
Dr. Kwiterovich says most of these kids with high cholesterol should do well with just diet and exercise and that very few would need medication.