Our latest Back to Basics is a wallchart highlighting key features about familial hypercholesterolaemia with links to other useful information.
Familial hypercholesterolaemia (FH) is a common monogenetic condition that causes high levels of cholesterol in the blood, resulting in an increased risk of heart disease at an early age. FH affects around one in every 270 people. That means that in England around 160,000 adults and 40,000 children under 18 years are likely to have FH, though only around 3,000 have been diagnosed by DNA testing. This article discusses the new implementation guide, which is designed to improve the identification and treatment of people with FH.
The benefits of lipid modification therapy in reducing cardiovascular disease (CVD) risk have been well recognised since the advent of effective treatments, including the HMG-CoA reductase inhibitors (statins). Use of statins is likely to have been a contributory factor in the fall of over 75% in CVD mortality in many industrialised countries over the last 40 years. Other interventions, including improved management of other cardiovascular risk factors, notably hypertension and smoking, have also been important. However, CVD continues to be responsible for one in four premature deaths in the UK, with rates in the most deprived 10% of the population being almost twice as high as in least deprived cohorts.
This article provides a pragmatic approach for primary care following NICE’s update to their guidance on identification and management of familial hypercholesterolaemia (CG 71) published in November 2017.
Raised blood cholesterol is a major risk factor in developing coronary heart disease and other cardiovascular diseases. Effective and well-tolerated lipid-lowering treatment improves outcomes for patients with elevated cholesterol, especially those with familial hypercholesterolaemia.
In the first 15 months of its operation, Bradford’s Healthy Hearts campaign has significantly improved the cardiovascular health of local people, and saved an estimated £1.2 m for the clinical commissioning group.
The British Heart Foundation is pressing for a renewed focus on improving the diagnosis and management of familial hypercholesterolaemia, and adoption of a nationwide cascade screening programme for first-degree relatives. The article includes best practice tips for busy primary healthcare professionals.
The European Atherosclerosis Society has conducted a survey to assess the general public’s understanding of cholesterol. Professor Mike Kirby summarizes the survey findings and highlights the importance of a clear and constant focus on the JBS3 2014 consensus recommendations.
Two injectable antibody-based therapies inhibiting the activity of PCSK9 – alirocumab and evolucumab – have recently been licensed. This paper reviews the current status of lipid management, the actions of PCSK9, and the clinical trial results achieved with PCSK9 inhibitors in early studies.
Recent advances in next generation sequencing (NGS) have reduced costs and made genetic diagnosis of familial hypercholesterolaemia (FH) quicker. This article reviews some of the technological breakthroughs in DNA testing in FH and benefits to patients and clinicians.
HEART UK – The Cholesterol Charity – has provided editorial support and review of this sponsored FH series.This article was made possible by an unrestricted educational grant by Sanofi, who had no control over content.
Volume 4, Supplement 1, May-June 2007
The updated guideline on lipid modification from the National Institute for Health and Care Excellence (NICE), which was published in summer 2014, has continued to cause a great deal of controversy, both among health professionals and the general public. Now that the dust has settled just a little, it is time to review the messages of this guideline in detail rather than relying on the headlines.