Advances, gaps and opportunities in the detection of familial hypercholesterolemia: overview of current and future screening and detection methods

Shirin Ibrahim, Laurens F. Reeskamp, Erik S.G. Stroes, Gerald F. Watts

Research output: Contribution to journalArticleResearchpeer-review

Abstract

PURPOSE OF REVIEW: Studies reaffirm that familial hypercholesterolemia is more prevalent than initially considered, with a population frequency of approximately one in 300. The majority of patients remains unidentified. This warrants critical evaluation of existing screening methods and exploration of novel methods of detection. RECENT FINDINGS: New public policy recommendations on the detection of familial hypercholesterolemia have been made by a global community of experts and advocates. Phenotypic tools for diagnosing index cases remain inaccurate. Genetic testing is the gold standard for familial hypercholesterolemia and a new international position statement has been published. Correction of LDL cholesterol (LDL-C) for the cholesterol content of lipoprotein(a) [Lp(a)] may increase the precision of the phenotypic diagnosis of familial hypercholesterolemia. Cascade cotesting for familial hypercholesterolemia and elevated Lp(a) levels provides a new opportunity to stratify risk in families. Digital technology and machine learning methods, coupled with clinical alert and decision support systems, lead the way in more efficient approaches for detecting and managing index cases. Universal screening of children, combined with child-parent cascade testing, appears to be the most effective method for underpinning a population strategy for maximizing the detection of familial hypercholesterolemia. SUMMARY: Detection of familial hypercholesterolemia can be enhanced by optimizing current diagnostic algorithms, probing electronic health records with novel information technologies and integrating universal screening of children with cascade testing of parents and other relatives.

Original languageEnglish
Pages (from-to)347-355
Number of pages9
JournalCurrent Opinion in Lipidology
Volume31
Issue number6
DOIs
Publication statusPublished - 1 Dec 2020

Fingerprint Dive into the research topics of 'Advances, gaps and opportunities in the detection of familial hypercholesterolemia: overview of current and future screening and detection methods'. Together they form a unique fingerprint.

Cite this