Treating Heterozygous (He) FH

Once you have been diagnosed with FH, although this in certain circumstances may be a possible diagnosis of FH or because treatment you are already receiving is not reducing your cholesterol levels to target, your physician may decide that the best way forward is to refer you to a Lipid Specialists Clinic.

In some countries, such as Australia, The Netherlands, UK and USA there are many such clinics and they are often within a short journey from your family physician's surgery. However this is not always the case and some countries either have very few or no Lipid Clinics. The International FH Foundation may well be able to assist in finding specialist clinicians who work in diabetes, hypertension or preventive cardiology clinics in countries where there may appear to be less obvious support.

It is very important to know that FH is treatable! For young children this treatment may initially be a well disciplined approach to lifestyle programmes ensuring that:

• Exercise is taken regularly
• A healthy and nutritious low fat diet is started, and
• Smoking is never started

Medication

These lifestyle changes are just as important for adults. Early adherence (up to about eight years of age) to a good lifestyle is likely to reap huge rewards.

However it will soon be necessary for FH children to be prescribed medication, which as with adults, is most likely to be a statin, but also fibrates, resins, cholesterol absorption inhibitors, nicotinic acid and omega 3, all to lower cholesterol levels.

Whilst each FH patient is different your family or specialist physician will work with you or your child to arrive at the best treatment. Target levels will be discussed and as a team, physician and patient will work towards achieving those goals.

For most FH adults the goal will be to at least halve LDL levels, say from 6 mmol/l (108 mg/dL) to 3 mmol/l (54 mg/dL). For those adults with a history of cardiovascular disease, reducing total cholesterol to 4mmol/l (72 mg/dL) or below is likely to be the target.

Once goals are achieved and treatment stabilised revisiting your specialist or family physician will become an annual event at which measurements will be taken to ensure the patient is achieving the best outcome.