Risk Based Guidance Tool

Risk Based Guidance Tool
Test Ages Risk Factors
Dyslipidemia 2 years and older

Dyslipidemia testing is recommended for anyone at increased risk for dyslipidemia, including:

Positive family history:

  • Premature coronary artery disease
  • Parent with known dyslipidemai or TC>240mg/dL (6.2 mmol/L)

Specific conditions:

  • Diabetes mellitus and familial hypercholesterolemia associated with high or moderate risk for CVD
  • Significant tobacco smoke exposure
  • Hyperstension


  • Elevated body mass index (BMI)
  • Children between 2 and 8 years of age with a BMI ≥95th percentile
  • Older children with a BMI ≥85th percentile
Type 2 diabetes 10 years, or onset of puberty if earlier

Type 2 diabetes testing is recommended for anyone at increased risk for type 2 diabetes, including:


  • BMI >85th percentile for age/gender
  • Weight for height >85th percentile
  • Weight >120% of ideal for height

Plus any two of the following:

Positive family history:

  • Type 2 diabetes in first-or second-degree relative


  • American Indian
  • African American
  • Latino
  • Asian American
  • Pacific Islander

Signs of insulin resistance or:

  • Acanthosis nigricans
  • Hypertension
  • Dyslipidemia
  • PCOS
  • Small for gestational age birth weight Maternal history of diabetes or GDM during the child’s gestation
Hepatitis C Any

HCV testing is recommended for anyone at increased risk for HCV infection, including:

Injected illegal drugs:

  • Persons who have ever injected illegal drugs, including those who injected only once many years ago

Selected medical conditions:

  • Patients who have ever received long-term hemodialysis treatment
  • All persons with HIV infection
  • Patients with signs or symptoms of liver disease (e.g., abnormal liver enzyme tests)
  • Children born to HCV-positive mothers (to avoid detecting maternal antibody, these children should not be tested before age 18 months)

HIV testing is recommended for anyone at increased risk for HIV infection, including:

Exposure or potential exposure:

  • Use of intravenous drugs
  • Sexual activity or abuse

History of an STI

Maternal-child transmission



Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents

Dyslipidemia in children: Definition, screening, and diagnosis

Type 2 Diabetes

Standards of Medical Care in Diabetes-2012

Hepatitis C

Hepatitis C FAQs for Health Professionals


Adolescents and HIV Infection: The Pediatrician’s Role in Promoting Routine Testing Committee on Pediatric AIDS Pediatrics 2011;128;1023; originally published online October 31, 2011; DOI: 10.1542/peds.2011-1761

Last updated August 14, 2018