Familial hypercholesterolaemia in children and adolescents: gaining decades of life by optimizing detection and treatment
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Familial hypercholesterolaemia in children and adolescents : gaining decades of life by optimizing detection and treatment. / Wiegman, Albert; Gidding, Samuel S; Watts, Gerald F; Chapman, M John; Ginsberg, Henry N; Cuchel, Marina; Ose, Leiv; Averna, Maurizio; Boileau, Catherine; Borén, Jan; Bruckert, Eric; Catapano, Alberico L; Defesche, Joep C; Descamps, Olivier S; Hegele, Robert A; Hovingh, G Kees; Humphries, Steve E; Kovanen, Petri T; Kuivenhoven, Jan Albert; Masana, Luis; Nordestgaard, Børge G; Pajukanta, Päivi; Parhofer, Klaus G; Raal, Frederick J; Ray, Kausik K; Santos, Raul D; Stalenhoef, Anton F H; Steinhagen-Thiessen, Elisabeth; Stroes, Erik S; Taskinen, Marja-Riitta; Tybjærg-Hansen, Anne; Wiklund, Olov; European Atherosclerosis Society Consensus Panel.
I: European Heart Journal, Bind 36, Nr. 36, 21.09.2015, s. 2425-37.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Familial hypercholesterolaemia in children and adolescents
T2 - gaining decades of life by optimizing detection and treatment
AU - Wiegman, Albert
AU - Gidding, Samuel S
AU - Watts, Gerald F
AU - Chapman, M John
AU - Ginsberg, Henry N
AU - Cuchel, Marina
AU - Ose, Leiv
AU - Averna, Maurizio
AU - Boileau, Catherine
AU - Borén, Jan
AU - Bruckert, Eric
AU - Catapano, Alberico L
AU - Defesche, Joep C
AU - Descamps, Olivier S
AU - Hegele, Robert A
AU - Hovingh, G Kees
AU - Humphries, Steve E
AU - Kovanen, Petri T
AU - Kuivenhoven, Jan Albert
AU - Masana, Luis
AU - Nordestgaard, Børge G
AU - Pajukanta, Päivi
AU - Parhofer, Klaus G
AU - Raal, Frederick J
AU - Ray, Kausik K
AU - Santos, Raul D
AU - Stalenhoef, Anton F H
AU - Steinhagen-Thiessen, Elisabeth
AU - Stroes, Erik S
AU - Taskinen, Marja-Riitta
AU - Tybjærg-Hansen, Anne
AU - Wiklund, Olov
AU - European Atherosclerosis Society Consensus Panel
N1 - © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2015/9/21
Y1 - 2015/9/21
N2 - 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 <3.5 mmol/L (130 mg/dL) if >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.
AB - 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 <3.5 mmol/L (130 mg/dL) if >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.
U2 - 10.1093/eurheartj/ehv157
DO - 10.1093/eurheartj/ehv157
M3 - Journal article
C2 - 26009596
VL - 36
SP - 2425
EP - 2437
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 36
ER -
ID: 160478430