FH report

HEART UK's assessment of London Health & Wellbeing Strategies highlights that cholesterol is often overlooked as a public health issue. 

 
A story of Hope

A Story of Hope is a short four-minute film about a family with a history of Familial Hypercholesterolemia.

 
FH medway report
Finding FH in GP practices Medway

80-90% of Familial Hypercholesterolemia​ (FH) cases remain undiagnosed. Two simple interventions improved diagnosis of genetic inherited high cholesterol in one CCG. Could your CCG establish a similar Familial Hypercholesterolemia programme? 

 

Making a diagnosis of FH

The Simon Broome Register Criteria and the Dutch Lipid Network criteria are the most commonly used criteria for diagnosing Familial Hypercholesterolaemia (FH)

Simon Broome Register Criteria:

This has been recommended by the National Institute for Health and Care Excellence (NICE) as the preferred clinical criteria for diagnosing FH, and includes cholesterol concentrations, clinical characteristics, molecular diagnosis and family history.

A: Definite familial hypercholesterolaemia is defined as:

Total cholesterol greater than 6.7mmol/L or low density lipoprotein cholesterol (LDL-C) greater than 4.0mmol/L in a child aged younger than 16 years or total cholesterol greater than 7.5mmol/L or LDL-C greater than 4.9mmol/L in an adult (levels either pre-treatment or highest on treatment)

Plus:

Tendon xanthomas in patient or in 1st degree relative (parent, sibling, child) or in 2nd degree relative (grandparent, uncle, aunt)

Or:

DNA-based evidence of an LDL receptor mutation or famiial defective apo B-100 or a PCSK9 mutation

B: Possible Familial Hypercholesterolaemia is defined as:

Total cholesterol greater than 6.7mmol/L or low density lipoprotein cholesterol (LDL-C) greater than 4.0mmol/L in a child aged younger than 16 years or total cholesterol greater than 7.5mmol/L or LDL-C greater than 4.9mmol/L in an adult (levels either pre-treatment or highest on treatment)

and at least one of the following:

Family history of myocardial infarction:younger than 50 years of age in a 2nd degree relative or younger than 60 in a 1st degree relative

Or

Family history of raised cholesterol greater than 7.5mmol/L in adult 1st or 2nd degree relative or greater than 6.7mmol/L in child or sibling aged younger than 16 years

The Dutch Lipid Clinics Network Criteria:

This is, as its name suggests, is commonly used to determine whether a patient may have FH in the Netherlands in a similar way to the Simon Broome Register criteria.  It is used to determine the likelihood of FH by assigning points for different symptoms/clinical history such as family history of hyperlipidaemia or heart disease, clinical characteristics such as tendon xanthoma, elevated LDL-Cl and/or an identified genetic mutation

  • a total point score of greater than 8 is considered "definite FH"
  • a total point score of 6-8 is considered "probable FH"
  • a total point score of 3-5 is considered "possible FH"

You can find out more about the Dutch Network score website here