6533b872fe1ef96bd12d429f
RESEARCH PRODUCT
Familial hypercholesterolæmia in children and adolescents: Gaining decades of life by optimizing detection and treatment
A. WiegmanS. GiddingG. WattsM. ChapmanH. GinsbergM. CuchelL. OseM. AvernaC. BoileauJ. BorénEric BruckertA. CatapanoJ. DefescheO. DescampsR. HegeleG. HovinghS. HumphriesP. KovanenJ. KuivenhovenL. MasanaB. NordestgaardP. PajukantaK. ParhoferF. RaalK. RayR. SantosA. StalenhoefE. Steinhagen ThiessenE. StroesM. TaskinenA. Tybjealigrg HansenO. WiklundA. CatapanoJ. DefescheO. DescampsS. GiddingH. GinsbergR. HegeleS. HumphriesP. KovanenB. NordestgaardK. ParhoferF. RaalK. RayR. SantosA. StalenhoefE. Steinhagen ThiessenE. StroesG. Wattssubject
CounselingEuropean Atherosclerosis Society Consensus PanelPediatricsCardiac & Cardiovascular SystemsSTATIN THERAPYSettore MED/09 - Medicina InternaVascular damage Radboud Institute for Health Sciences [Radboudumc 16]Familial hypercholesterolemiaAdolescentsCarotid Intima-Media ThicknessINTIMA-MEDIA THICKNESSCost of IllnessPregnancyRisk FactorsDiagnosisYOUNG-ADULTSHIPERCOLESTEROLEMIA (DIAGNÓSTICO;TERAPIA;TENDÊNCIAS)Family historyYoung adultChildChildrenEvidence-Based Medicinemedicine.diagnostic_testHomozygoteMiddle AgedFamilial hypercholesterolæmia3. Good healthEconomics MedicalAdolescents; Children; Consensus statement; Diagnosis; Ezetimibe; Familial hypercholesterolæmia; LDL cholesterol; PCSK9 inhibitor; Statin; Treatment; Cardiology and Cardiovascular MedicineCARDIOVASCULAR-DISEASEConsensus statementLDL cholesterolFemalelipids (amino acids peptides and proteins)Cardiology and Cardiovascular MedicineFamilial hypercholesterolaemiaLife Sciences & BiomedicineDiagnosimedicine.drugAdultHeterozygotemedicine.medical_specialtyStatinAdolescentmedicine.drug_classPCSK9 inhibitorENDOTHELIAL FUNCTIONLOW-DENSITY-LIPOPROTEINReviewsCOST-EFFECTIVENESS ANALYSIS1102 Cardiovascular Medicine And HaematologyMedication AdherenceHyperlipoproteinemia Type IIYoung AdultLife ExpectancyEzetimibemedicineHumansCORONARY-HEART-DISEASEGenetic TestingGenetic testingPregnancyScience & TechnologyClinical Laboratory Techniquesbusiness.industryPreventionStatinAtherosclerosismedicine.diseaseEzetimibeDietASSOCIATION EXPERT PANELBLOOD-PRESSURE RESEARCHPregnancy ComplicationsTreatmentEarly DiagnosisIntima-media thicknessCardiovascular System & HematologyDietary SupplementsPhysical therapyCardiovascular System & Cardiologybusinessdescription
Contains fulltext : 155263.pdf (Publisher’s version ) (Open Access) Familial hypercholesterolaemia (FH) is a common genetic cause of premature coronary heart disease (CHD). Globally, one baby is born with FH every minute. If diagnosed and treated early in childhood, individuals with FH can have normal life expectancy. This consensus paper aims to improve awareness of the need for early detection and management of FH children. Familial hypercholesterolaemia is diagnosed either on phenotypic criteria, i.e. an elevated low-density lipoprotein cholesterol (LDL-C) level plus a family history of elevated LDL-C, premature coronary artery disease and/or genetic diagnosis, or positive genetic testing. Childhood is the optimal period for discrimination between FH and non-FH using LDL-C screening. An LDL-C >/=5 mmol/L (190 mg/dL), or an LDL-C >/=4 mmol/L (160 mg/dL) with family history of premature CHD and/or high baseline cholesterol in one parent, make the phenotypic diagnosis. If a parent has a genetic defect, the LDL-C cut-off for the child is >/=3.5 mmol/L (130 mg/dL). We recommend cascade screening of families using a combined phenotypic and genotypic strategy. In children, testing is recommended from age 5 years, or earlier if homozygous FH is suspected. A healthy lifestyle and statin treatment (from age 8 to 10 years) are the cornerstones of management of heterozygous FH. Target LDL-C is 10 years, or ideally 50% reduction from baseline if 8-10 years, especially with very high LDL-C, elevated lipoprotein(a), a family history of premature CHD or other cardiovascular risk factors, balanced against the long-term risk of treatment side effects. Identifying FH early and optimally lowering LDL-C over the lifespan reduces cumulative LDL-C burden and offers health and socioeconomic benefits. To drive policy change for timely detection and management, we call for further studies in the young. Increased awareness, early identification, and optimal treatment from childhood are critical to adding decades of healthy life for children and adolescents with FH.
year | journal | country | edition | language |
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2015-02-16 |