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Feature Article

Improving care in familial hypercholesterolaemia

Gerald Watts, David Sullivan

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Abstract

Most people with FH in Australia and New Zealand are unrecognised and inadequately treated. To bridge this gap in coronary prevention, the FH Australasia Network has developed a model of care for patients with FH, focusing on detecting, diagnosing, assessing and managing index cases, as well as on risk notification and cascade screening of family members.

Key Points

  • At least 45,000 people have FH in Australia and New Zealand, but most are unrecognised and inadequately treated.
  • The FH Australasia Network has developed a model of care for patients with FH (summarised in this article) that focuses on detecting, diagnosing, assessing and managing index cases of FH, as well as risk notification and cascade screening of family members.
  • Index cases of FH should be sought among adults with premature cardiovascular disease in different clinical settings, and all patients considered to have FH should be referred to a lipid disorders clinic for further assessment and institution of cascade screening.
  • Not all patients with FH have the same risk of CHD; hence, risk stratification of patients determined by the presence of cardiovascular risk factors and a personal history of cardiovascular disease should be used to guide the intensity of medical management.

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