Hormonal
Early and aggressive LDL cholesterol lowering in Familial Hypercholesterolemia (FH) patients significantly reduces cumulative LDL burden and prevents premature coronary heart disease (CHD).
If you or your child has Familial Hypercholesterolemia (FH), do not wait for symptoms. Start maximal statin therapy immediately upon diagnosis to lower LDL cholesterol to specific targets (e.g., <100 mg/dL for adults). This prevents the cumulative damage that leads to heart attacks in your 30s or 40s. Combine medication with lifestyle changes (diet, exercise, no smoking).
The concept of a cumulative LDL cholesterol burden (Figure 8) illustrates the importance of early treatment... For an individual with heterozygous FH, this LDL cholesterol burden is reached by age 35 if untreated, by age 48 if treated since age 18, and by age 53 if treated since age 10.
Why this rating
Based on large population studies (Copenhagen General Population Study) and consensus guidelines, though specific RCTs in FH are noted as ethically difficult.
Source
Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: Consensus Statement of the European Atherosclerosis Society
Børge G. Nordestgaard et al. · European Heart Journal · 2013
DOI 10.1093/eurheartj/eht273
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