Pediatric preventive cardiology: experience in the Tidewater, Virginia area. 
The Division of Pediatric Cardiology began a preventive cardiology program in response to the American Academy of Pediatrics (AAP) Nutrition Committee recommendations on pediatric cholesterol screening.  This program has consisted of both public and physician educational programs as well as the treatment of individual hyperlipidemic children.  A survey of 67 local pediatricians has revealed that they have not followed the AAP directive for a "family history" approach to pediatric cholesterol screening, with most pediatricians screening all their patients for cholesterol abnormalities.  Our dietary treatment program for hyperlipidemic children has given good short-term results, lowering mean total cholesterol concentrations by 10% (23 mg/dl) and mean low density lipoprotein cholesterol (LDL) concentrations by 9.3% (16 mg/dl), as well as decreasing the total cholesterol/high density lipoprotein cholesterol (HDL) ratio by 10% (0.6).  The additional use of cholestyramine in nine selected patients has effected even greater mean value decreases of 45 mg/dl or 16% (total cholesterol), 44 mg/dl or 19% (LDL), and 1.3 or 19% (total cholesterol/HDL ratio).  All these changes are statistically significant (p less than 0.05).  These encouraging short-term results hopefully will promote the long-term goal of decreasing the incidence of coronary artery disease, which remains the leading cause of death in our country.