No information was available regarding cardiovascular outcomes.
Whereas the American College of Cardiology and American Heart Association recommend an initial lipid screening for all adults older than 20yrs, the US Preventive Services Task Force (USPTF) recommends delayed screening until at the age of 35 years or later in men, or 45 years or later in women.
In a related editorial, the authors note that because the primary analysis excluded all persons younger than 50 years who were receiving statins or who already had a major vascular event (whilst these people were likely to have had a strong family history or elevated cholesterol levels) the analysis was actually conducted to identify those at high risk, and this systematic bias might alter the effective screening rates.
The authors conclude by disagreeing with the USPTF recommendation to delay lipid screening, and suggest that LDL-C screening should be universally recommended for all patients in their late teens or early adult years.
In the UK, National Institute for Health and Care Excellence (NICE) suggests prioritising people on the basis of an estimate of their cardiovascular disease risk before a full formal risk assessment, recommending that CVD risk should be assessed using CVD risk factors already recorded in primary care electronic medical records. People older than 40 should have their estimate of CVD risk reviewed on an ongoing basis.