Managing Familial Hypercholesterolemia: Expert Guidelines for Patients and Doctors

Early Diagnosis and Treatment

Guidelines emphasize the importance of early FH diagnosis and treatment. The National Lipid Association recommends universal cholesterol screening by age 11, with earlier testing for children with a family history of FH or early heart disease. Treatment often begins in childhood, typically between ages 8-10 for those with heterozygous FH. For adults, treatment should start immediately upon diagnosis.

LDL Cholesterol Targets

Lowering LDL cholesterol is the primary goal of FH treatment. For adults with FH, the European Atherosclerosis Society recommends an LDL target of <100 mg/dL for primary prevention, and <70 mg/dL for those with existing heart disease. Some experts suggest even lower targets of <55 mg/dL for very high-risk patients. Children's targets are typically set at <130 mg/dL.

Stepwise Treatment Approach

Guidelines recommend a stepwise approach to treatment. High-intensity statin therapy is the first-line treatment for most patients. If LDL goals aren't met with statins alone, ezetimibe is typically added next. For patients still not at goal, PCSK9 inhibitors are recommended. LDL apheresis may be considered for severe cases, particularly those with homozygous FH.

Frequently Asked Questions

Key Takeaways

While guidelines provide a framework, FH management should be tailored to each patient's unique needs and risks.

Related Articles

• What is Familial Hypercholesterolemia and Why Should You Care?
• Treating Familial Hypercholesterolemia: A Guide to Lowering Sky-High Cholesterol
• Are You at Risk for Familial Hypercholesterolemia? Key Factors to Know
• Diagnosing Familial Hypercholesterolemia: From Blood Tests to Genetic Screening

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