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Treating Familial Hypercholesterolemia: A Guide to Lowering Sky-High Cholesterol
Published: Jan 02, 2024
Familial hypercholesterolemia (FH) causes dangerously high cholesterol, but effective treatments are available. Learn how doctors tackle this genetic condition to protect heart health.
Statins: The First Line of Defense
High-dose statin medications are the cornerstone of FH treatment. These drugs, like atorvastatin or rosuvastatin, work by reducing the liver's cholesterol production. For many FH patients, statins can lower LDL cholesterol by 50% or more. However, they're often not enough on their own to reach target cholesterol levels.
Beyond Statins: Additional Medications
When statins aren't enough, doctors add other cholesterol-lowering drugs. Ezetimibe blocks cholesterol absorption in the intestines. PCSK9 inhibitors, given as injections, dramatically boost the body's ability to remove LDL from the blood. For severe cases, drugs like lomitapide may be used, though they can have significant side effects.
LDL Apheresis: Filtering the Blood
Some FH patients, especially those with the more severe homozygous form, may need LDL apheresis. This procedure, similar to dialysis, filters LDL cholesterol directly from the blood. It's typically done every 1-2 weeks and can lower LDL levels by 60-70% each time.
Lifestyle Changes: Supporting Treatment
While medications are crucial for FH, lifestyle changes play a supporting role. A heart-healthy diet low in saturated fat, regular exercise, and avoiding smoking can all help manage cholesterol levels and reduce overall heart disease risk. These changes are important but not sufficient on their own to treat FH.
Frequently Asked Questions
Doctors typically aim for LDL below 100 mg/dL, or even lower for high-risk patients.
Yes, FH requires lifelong management to control cholesterol levels.
Yes, treatment often starts in childhood, usually with statins.
A Brighter Future
With proper treatment, people with FH can significantly reduce their risk of early heart disease and live long, healthy lives.
References
- Raal FJ, et al. Lancet. 2015;385(9965):331-340.
- Cuchel M, et al. J Clin Lipidol. 2014;8(3 Suppl):S72-S81.
- Goldberg AC, et al. J Clin Lipidol. 2011;5(3 Suppl):S1-S8.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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