Case studies

Father and daughter with the same cholesterol problem

Leon A Simons



The initiation of statin therapy in middle-aged people with cholesterol problems is relatively straightforward; however, in teenagers with heterozygous familial hypercholesterolaemia the timing of statin introduction is complex and specialist advice may be required.

Key Points

  • Patients with heterozygous familial hypercholesterolaemia (HFH) are at high risk of premature cardiovascular disease, and statin therapy is strongly indicated.
  • High-dose statin therapy in combination with a second drug such as ezetimibe may be required to achieve goal LDL cholesterol levels in some patients.
  • The children of patients with HFH should be tested for this condition. Affected patients will need dietary and statin therapy.
  • The timing of introduction of statin therapy in teenagers is problematical and specialist advice may be required.