Optimising the Detection and Management of Familial Hypercholesterolaemia: Central Role of Primary Care and its Integration with Specialist Services
Familial hypercholesterolaemia (FH) is the most common monogenic lipid disorder associated with premature coronary heart disease (CHD). However, the majority of people with FH are undiagnosed or undertreated. Early cholesterol lowering therapy reduces cardiovascular disease mortality in FH. Low awar...
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Published in | Heart, lung & circulation Vol. 23; no. 12; pp. 1158 - 1164 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Australia
Elsevier B.V
01.12.2014
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Abstract | Familial hypercholesterolaemia (FH) is the most common monogenic lipid disorder associated with premature coronary heart disease (CHD). However, the majority of people with FH are undiagnosed or undertreated. Early cholesterol lowering therapy reduces cardiovascular disease mortality in FH. Low awareness and knowledge of FH in specialty and general practice highlights the need for strategies to improve the detection and management of FH. We present an algorithm describing a multidisciplinary approach to FH detection and management. We highlight the role of primary care, and where GPs can work with preventive cardiologists to improve care of FH. Novel strategies to detect index cases with FH are presented including the community laboratory, highlighting patients at high risk of FH, and targeted FH detection through searching the general practice database. General practitioners request over 90% of LDL cholesterol measurements in the community. Once an individual with FH is detected only a small proportion of patients require specialty management with the majority of patients suitably managed in primary care. However, it is crucial to screen family members, as 50% of first-degree family members are expected to have FH due to the autosomal dominant inheritance. |
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AbstractList | Familial hypercholesterolaemia (FH) is the most common monogenic lipid disorder associated with premature coronary heart disease (CHD). However, the majority of people with FH are undiagnosed or undertreated. Early cholesterol lowering therapy reduces cardiovascular disease mortality in FH. Low awareness and knowledge of FH in specialty and general practice highlights the need for strategies to improve the detection and management of FH.
We present an algorithm describing a multidisciplinary approach to FH detection and management. We highlight the role of primary care, and where GPs can work with preventive cardiologists to improve care of FH. Novel strategies to detect index cases with FH are presented including the community laboratory, highlighting patients at high risk of FH, and targeted FH detection through searching the general practice database.
General practitioners request over 90% of LDL cholesterol measurements in the community. Once an individual with FH is detected only a small proportion of patients require specialty management with the majority of patients suitably managed in primary care. However, it is crucial to screen family members, as 50% of first-degree family members are expected to have FH due to the autosomal dominant inheritance. Familial hypercholesterolaemia (FH) is the most common monogenic lipid disorder associated with premature coronary heart disease (CHD). However, the majority of people with FH are undiagnosed or undertreated. Early cholesterol lowering therapy reduces cardiovascular disease mortality in FH. Low awareness and knowledge of FH in specialty and general practice highlights the need for strategies to improve the detection and management of FH. We present an algorithm describing a multidisciplinary approach to FH detection and management. We highlight the role of primary care, and where GPs can work with preventive cardiologists to improve care of FH. Novel strategies to detect index cases with FH are presented including the community laboratory, highlighting patients at high risk of FH, and targeted FH detection through searching the general practice database. General practitioners request over 90% of LDL cholesterol measurements in the community. Once an individual with FH is detected only a small proportion of patients require specialty management with the majority of patients suitably managed in primary care. However, it is crucial to screen family members, as 50% of first-degree family members are expected to have FH due to the autosomal dominant inheritance. |
Author | Bell, Damon, FRACP, FRCPA Vickery, Alistair W., FRACGP Garton-Smith, Jacquie, FRACGP Watts, Gerald F., DSc, MD, PhD, FRACP Kirke, Andrew B., FRACGP Pang, Jing, PhD |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25130889$$D View this record in MEDLINE/PubMed |
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Copyright | Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. |
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Keywords | Genetic predisposition to disease Cardiovascular diseases Primary health care Mass screening Familial hypercholesterolaemia |
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SubjectTerms | Algorithms Cardiovascular Cardiovascular diseases Cholesterol, LDL - blood Education, Medical, Continuing Familial hypercholesterolaemia Female General Practitioners Genetic predisposition to disease Genetic Testing Humans Hyperlipoproteinemia Type II - blood Hyperlipoproteinemia Type II - diagnosis Hyperlipoproteinemia Type II - genetics Hyperlipoproteinemia Type II - therapy Male Mass screening Primary Health Care |
Title | Optimising the Detection and Management of Familial Hypercholesterolaemia: Central Role of Primary Care and its Integration with Specialist Services |
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