Resources for all healthcare professionals to support the early detection and management of patients with Familial Hypercholesterolaemia in the East Genomics region.
Familial Hypercholesterolaemia (FH) is an inherited genetic condition that causes high levels of cholesterol in the blood. High levels of cholesterol increase the risk of developing cardiovascular disease or having a heart attack at a much younger age. If FH is left untreated, 50% of affected males will have cardiovascular disease by the age of 50 and 30% of women will have cardiovascular disease by the age of 60. Early treatment and management of FH significantly improves cardiovascular outcomes.
FH is a genetic condition where the gene changes that cause FH disrupt the normal expression of genes that regulate serum cholesterol levels. FH is usually an autosomal dominant genetic disorder. This means that, first degree relatives of a patient with FH will have a 50% chance of also being affected.
FH is common in the UK population with at least one in 500 individuals thought to be affected. However, current estimates suggest that only 10-15% of individuals affected are actually aware that they have FH.
Patients with a high likelihood of FH can be identified through cholesterol testing, physical examination and reviewing family history of cardiovascular disease. Confirmation of a FH diagnosis using genetic testing may inform on treatment and management, and will enable cascade testing to identify affected relatives.
HEART UK has produced three short videos for healthcare professionals (opens in a new tab) on understanding, diagnosing and treating FH.
Identifying Patients with Familial Hypercholesterolaemia
The NHS Long Term Plan (opens in a new tab) aims to increase the number of individuals tested for FH to improve patient outcomes. To support these aims, genetic testing for FH is now centrally commissioned by NHS England and all healthcare professionals in the East of England and East Midlands can order FH genetic testing for their patients.
See our other FH information pages:
Lipid Clinics in the East Midlands and East of England
Lipid Clinic (opens in a new tab) contact details in the East Midlands and East of England
Further guidance including identifying and managing FH and lipid management
- NICE Clinical guidelines for identifying and managing FH (opens in a new tab) – covers diagnosis, identifying people with FH using cascade testing, drug treatment, lifestyle interventions and specialist treatment, information and support on contraception for women with FH and for pregnant women with FH, and review and referral for evaluation of coronary heart disease.
- Lipid Management Resources (opens in a new tab) - Eastern AHSN is working with local healthcare services to improve lipid management in the region. They have produced a collection of free resources to support clinicians and wider NHS colleagues, including a guide to lipid management in primary care, which can be requested through their website.
- Primary Care PCN Network Contract DES IIF (opens in a new tab) - the NHS Long Term Plan commits to increasing the diagnosis of FH from 7% to 25% by 2024/25. This indicator recognises PCNs for systematically searching their patient list to identify those with possible FH, excluding any potential secondary causes, assessing further using Simon Broome or Dutch Lipid Network criteria, and then referring on for specialist assessment and/or genetic testing for FH in line with local pathways.
- Simon Broome guidance (opens in a new tab)
Educational Resources for Health Care Professionals
- Royal College of General Practitioners Management of FH in General Practice (opens in a new tab) – information about the causes and consequences of FH, how GPs vcan identify those in their practice most likely to have FH, and how these patients and their relatives should be managed, plus genetic causes of FH, the ongoing study into identifying FH in infants, and describes novel lipid-lowering agents. Requires login to access.
- Genomics Education Program – Familial Hypercholesterolemia Transformation Project (opens in a new tab)
- A collection of resources to support delivery of the national FH Transformation Project