Red Flags of Familial Hypercholesterolemia

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Red Flags of Familial Hypercholesterolemia The following are family and personal history signs that may suggest familial hypercholesterolemia (FH). They are based on guidelines from the National Institute for Health and Care Excellence (NICE) in the U.K. and the Simon Broome Diagnostic Criteria, as well as guidelines from the U.S. National Lipid Association. Y/N Red Flag Additional Information Early age of onset for coronary For men< 50 years old artery disease in self or in For women < 60 years old (Simon Broome Criteria) family (includes heart attack, For men < 55 years old stent, bypass) For women < 65 years old (National Lipid Association) For men< 50 years For women < 60 years old (Simon Broome Criteria) Family history of sudden death For men < 55 years For women < 65 years old (National Lipid Association) Total cholesterol ≥220 mg/dL Should be untreated and fasting cholesterol levels; other or LDL cholesterol ≥190 mg/dL causes of hyperlipidemia should be ruled out (NICE) in individual Tendon xanthomas Typically found on the Achilles tendon, and finger extensor (NICE, National Lipid Association) If your patient has even one “Yes”, they are suspected of having FH. Next Steps: • At least a three-generation pedigree that includes the following: o Age of onset of coronary heart disease o Lipid concentrations o Smoking history o If deceased, cause and age of death • Cholesterol screening (if it was not done previously) o Patient should be fasting and not on medication o Rule out other causes of hypercholesterolemia (i.e. diet, lack of exercise) • Referral to a cardiovascular genetics specialist for consideration of genetic testing For additional information, please see: • https://www.nice.org.uk/guidance/QS41/chapter/List-of-quality-statements • http://www.ncbi.nlm.nih.gov/books/NBK53810/ • Goldberg AC, Hopkins PN, Toth PP, et al. Familial Hypercholesterolemia: Screening, diagnosis and management of pediatric and adult patients. J Clin Lipidol. 2011;5:133-140. Developed by: Emily Smith, MS, CGC Program for Cardiovascular Genetics, Section of Cardiovascular Medicine Yale School of Medicine Phone: 203.737.5500 Email: [email protected] .

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An Educational Booklet for Patients with Familial Hypercholesterolemia
Illustrations > Jean Lambert Illustrations graphic design > www.mine-de-rien.net graphic Chol/29/P030/01-01/10 NLA An educational booklet for patients with familial hypercholesterolemia This brochure was provided by Genzyme Corporation for use by the Foundation of the National Lipid Association. DR. LEIV OSE www.learnyourlipids.com CONTENTS PART 1 What will you learn from this booklet? 02 FAMILIAL HYPERCHOLESTEROLEMIA PART 1: FAMILIAL HYPERCHOLESTEROLEMIA 03 1 - What is Familial Hypercholesterolemia? 03 WHAT WILL YOU 2 - What is LDL-Cholesterol? 04 3 - What are the causes of FH? 05 LEARN FROM THIS GREAT GRANDMOTHER GREAT GRANDFATHER 4 - When should FH be suspected? 07 FH NON FH BOOKLET? 5 - How is FH diagnosed? 09 6 - How early can FH be diagnosed? 09 Woman You will learn about Familial PART 2: TREATMENT 10 GRANDMOTHER GRANDFATHER Hypercholesterolemia, NON FH FH Woman with FH 1 - How can LDL-Cholesterol be reduced? 10 its cause, and the potential 2 - Step 1: Dietary management of FH 11 Man consequences of this a) How does diet affect LDL-Cholesterol? 11 disease. You will learn b) What sort of diet? 11 Man with FH about high cholesterol 3 - Step 2: Using medication 12 AUNT MOTHER FATHER UNCLE and what this might mean a) How does medication affect LDL-Cholesterol? 12 NON FH FH NON FH FH for your heart and blood b) Which drug treatments reduce LDL-Cholesterol and how? 13 FIGURE 1: 4 - Why is lifelong treatment important? vessels. Most importantly 15 FH is an inherited disease, you will learn how to find PART 3: CARDIOVASCULAR DISEASE AND LIPOPROTEINS 16 which can usually be traced out whether someone in 1 - What is cardiovascular disease? 16 DAUGTER SON over several generations.
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