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Published on: September 15, 2018
Familial Hypercholesterolemia: From Clinical Suspicion to Novel Treatments
Saeid Mirzai1, Parag Anilkumar Chevli2, Rishi Rikhi3
1Department of Internal Medicine, Cleveland Clinic, Cleveland, OH 44195, USA.
Insights
Familial hypercholesterolemia (FH) is a common genetic disorder causing high LDL cholesterol from birth, increasing early cardiovascular disease (CVD) risk. Early diagnosis and treatment are crucial for managing FH and preventing CVD.
Area of Science:
- Genetics
- Cardiology
- Public Health
Background:
- Familial hypercholesterolemia (FH) is the most common monogenic disorder globally.
- It leads to elevated low-density lipoprotein cholesterol (LDL-C) from birth, significantly increasing premature cardiovascular disease (CVD) risk.
Purpose of the Study:
- To review the importance of early diagnosis of FH.
- To discuss available treatment options for FH.
- To emphasize the need for increased awareness and screening for FH.
Main Methods:
- Literature review focusing on FH diagnosis and treatment.
- Analysis of current challenges in FH identification.
- Discussion of recommended screening and testing protocols.
Main Results:
- Delayed diagnosis is a major barrier to effective FH management.
- Early and aggressive LDL-C lowering therapies are recommended.
- Cascade lipid and/or genetic testing in first-degree relatives is advised due to autosomal dominant inheritance.
Conclusions:
- Early FH diagnosis is critical for mitigating CVD risk.
- Improved screening and awareness can lead to better patient outcomes.
- Timely treatment of FH reduces the long-term burden of cardiovascular disease.
Abstract:
Familial hypercholesterolemia (FH) is the most common monogenic disorder in humans. It affects millions of people globally, increasing the risk of developing cardiovascular disease (CVD) at a younger age due to elevated levels of low-density lipoprotein cholesterol (LDL-C) from birth. While effective traditional and novel treatments are available, the most significant challenge with FH is the lack of timely diagnosis. As a result, many patients remain undertreated leading to an increased risk of CVD. To mitigate risk, initiating early and aggressive LDL-C-lowering therapies is recommended. Moreover, given its autosomal dominant inheritance patterns, it is also recommended to perform cascade lipid and/or genetic testing of all first-degree relatives. This review highlights the importance of early FH diagnosis and available treatment options. Greater awareness and improved screening efforts can help diagnose and treat more individuals, ultimately reducing the CVD risk associated with FH.
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