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Published on: September 15, 2018
Preventing early cardiovascular death in patients with familial hypercholesterolemia
Thomas B Repas1, J Ross Tanner
1Regional Medical Clinic - Endocrinology, 640 Flormann St, Rapid City, SD 57701-4649. trepas@regionalhealth.com.
Insights
Familial hypercholesterolemia (FH) is a genetic condition causing high cholesterol and early heart disease. Early screening and treatment, including statins or apheresis, are crucial for managing FH and preventing life-threatening events.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Metabolic Disorders
Background:
- Familial hypercholesterolemia (FH) is an autosomal dominant genetic disorder.
- It leads to severely elevated total and LDL cholesterol levels.
- FH affects over 600,000 individuals in the US, causing premature cardiovascular disease.
Purpose of the Study:
- To review the screening, diagnosis, and management of Familial hypercholesterolemia.
- To highlight the importance of identifying and treating FH to prevent cardiovascular events.
Main Methods:
- Review of current literature on FH screening protocols.
- Analysis of pharmacologic (statins, lipid-lowering medications) and non-pharmacologic (LDL apheresis) treatment options.
- Discussion of diagnostic criteria and management guidelines for FH.
Main Results:
- FH is significantly underdiagnosed and undertreated despite its prevalence.
- Pharmacotherapy, particularly statins, is effective in managing FH.
- LDL apheresis serves as a vital non-pharmacologic option for non-responsive or intolerant patients.
Conclusions:
- Screening for FH is essential for early detection and intervention.
- Timely diagnosis and appropriate management, including drug therapy, can significantly reduce mortality.
- A comprehensive approach to FH management can save lives and prevent premature cardiovascular death.
Abstract:
Familial hypercholesterolemia (FH) is an autosomal dominant disorder resulting in severe elevation of total and low-density lipoprotein cholesterol levels. There are more than 600,000 individuals in the United States with FH. Individuals with FH tend to experience premature cardiovascular disease and often die from sudden cardiac death at a young age. Statins alone or in combination with other lipid-lowering medications are effective in managing FH and preventing cardiovascular events. For patients who do not respond to or are intolerant of pharmacotherapy, low-density lipoprotein apheresis is available as a nonpharmacologic treatment option. Despite the prevalence of FH, it is undiagnosed and untreated in the majority of patients. Screening, combined with appropriate drug therapy, can save lives. The authors review the screening, diagnosis, and management of FH.
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