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Familial Hypercholesterolemia: Screening, diagnosis and management of pediatric and adult patients
Abstract
The familial hypercholesterolemias (FH) are a group of genetic defects resulting in severe elevations of blood cholesterol levels and increased risk of premature coronary heart disease. FH is among the most commonly occurring congenital metabolic disorders. FH is a treatable disease. Aggressive lipid lowering is necessary to achieve the target LDL cholesterol reduction of at least 50% or more. Even greater target LDL cholesterol reductions may be necessary for FH patients who have other CHD risk factors. Despite the prevalence of this disease and the availability of effective treatment options, FH is both underdiagnosed and undertreated, particularly among children. Deficiencies in the diagnosis and treatment of FH indicate the need for greatly increased awareness and understanding of this disease, both on the part of the public and of healthcare practitioners. This document provides recommendations for the screening, diagnosis and treatment of FH in pediatric and adult patients developed by the National Lipid Association Expert Panel on Familial Hypercholesterolemia. This report goes beyond previously published guidelines by providing specific clinical guidance for the primary care clinician and lipid specialist with the goal of improving care of patients with FH and reducing their elevated risk for CHD.
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“This risk is accelerated in the presence of other ASCVD risk factors (22,23).”
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Agarwala, A., & Goldberg, A. C. (2021) · Current Atherosclerosis Reports · doi:10.1007/s11883-021-00942-3 · Cited by 8
Parental Attitudes and Ideas Regarding Newborn Screening for Familial Hypercholesterolemia
Tobik, K., Orland, K. M., Zhang, X., Garcia, K., & Peterson, A. L. H. (2023) · Maternal and Child Health Journal · doi:10.1007/s10995-023-03640-5 · Cited by 8
Aspirin for primary prevention of cardiovascular disease: What do the current USPSTF guidelines say?
Mallick, S., Shroff, G. R., & Linzer, M. (2023) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.90a.22087 · Cited by 8
Genetic Testing in Hyperlipidemia
Bilen, O., Pokharel, Y., & Ballantyne, C. M. (2015) · Cardiology Clinics · doi:10.1016/j.ccl.2015.02.006 · Cited by 8
Li, H., Zhang, Y., Wei, X., Peng, Y. H., Yang, P., Tan, H., Chen, C., Pan, Q., Liang, D., & Wu, L. (2015) · Gene · doi:10.1016/j.gene.2015.04.071 · Cited by 8
Shi, H.-W., Yang, J., Wang, Y., Li, W., Guo, Y., Gao, Y., Tang, Y., Li, J., Wu, N., & Yang, Y. (2020) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2020.00113 · Cited by 8
Peterson, A. L. H., Bang, M., Block, R., Wong, N. D., & Karalis, D. G. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10143090 · Cited by 9
Winchester, B., Cragun, D. L., Redlinger‐Grosse, K., Walters, S. T., Ash, E., Baldry, E. L., & Zierhut, H. A. (2022) · Journal of Genetic Counseling · doi:10.1002/jgc4.1554 · Cited by 8
Dagli-Hernandez, C., Borges, J. B., Marçal, E. D. S. R., de Freitas, R. C. C., Mori, A. A., Gonçalves, R. M., Faludi, A. Á., de Oliveira, V. F., Ferreira, G. M., Bastos, G. M., et al. (2022) · Pharmaceutics · doi:10.3390/pharmaceutics14050944 · Cited by 8
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“The diagnosis of FH remains a clinical challenge despite advancements in lipid profiling, genetic testing, and established scoring systems such as the Dutch Lipid Clinic Network (DLCN) score [4, 150].”
Thajer, A., Baumgartner-Kaut, M., Jorda, A., Hallwirth, U., Lischka, J., & Greber‐Platzer, S. (2022) · Children · doi:10.3390/children9050590 · Cited by 7
Kumar, P. M., Prasad, S. R., Anand, A., Kumar, R., & Ghosh, S. (2022) · The Egyptian Heart Journal · doi:10.1186/s43044-022-00320-7 · Cited by 7
Metadata
- Authors
- Goldberg, A. C., Hopkins, P. N., Toth, P. P., Ballantyne, C. M., Rader, D. J., Robinson, J. G., Daniels, S. R., Gidding, S. S., de Ferranti, S. D., Ito, M. K., McGowan, M. P., Moriarty, P. M., Cromwell, W. C., Ross, J. L., & Ziajka, P. E.
- Affiliations
- Washington University in St. Louis (US)
- University of Utah (US)
- CGH Medical Center (US)
- Baylor College of Medicine (US)
- University of Pennsylvania (US)
- University of Iowa (US)
- Children's Hospital Colorado (US)
- Alfred I. duPont Hospital for Children (US)
- Oregon State University (US)
- Concord Hospital (US)
- University of Kansas Medical Center (US)
- Wake Forest University (US)
- University of Pennsylvania Health System (US)
- Corresponding author
- Goldberg, Anne C.
- ORCID
- Venue
- Journal of clinical lipidology
- Publisher
- Elsevier BV
- Published
- 2011-05
- Volume
- 5
- Issue
- 3
- Pages
- 133-140
- ISSN
- 1876-4789 (ISSN-L)
- 1933-2874
- OpenAlex
- W2943032204
- Cited by
- 622
- References
- 163
- Citations by year
- 2026: 13 · 2025: 16 · 2024: 15 · 2023: 22 · 2022: 23 · 2021: 55 · 2020: 53 · 2019: 39 · 2018: 63 · 2017: 47 · 2016: 76 · 2015: 58 · 2014: 56 · 2013: 47 · 2012: 28
- FWCI
- 45.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of clinical lipidology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Cholesterol and Lipid Metabolism
- Keywords
- familial hypercholesterolemia, screening, diagnosis, lipid-lowering therapy, LDL cholesterol lowering, coronary heart disease risk, pediatric patients, underdiagnosis, primary care, genetic lipid disorders
- MeSH terms
- Proprotein Convertase 9, Adult, Anticholesteremic Agents, Apolipoproteins B, Child, Coronary Disease, Genetic Testing, Homozygote, Humans, Hyperlipoproteinemia Type II, Mutation, Serine Endopeptidases, Practice Guidelines as Topic, LDL-Receptor Related Proteins, Proprotein Convertases
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