Familial hypercholesterolaemia in adults : management summary CKS NICE

A table summarising the key points -drug treatment of adults with FH as recommended by NICE

Criteria/Population	Action/Management	Rationale
Suspected FH in Adults	♦ Total cholesterol > 7.5 mmol/L and/or ♦ Personal or family history of premature CHD	Identifies high-risk patients who may benefit from early intervention
Systematic Search in Primary Care	♦ Age < 30, total cholesterol > 7.5 mmol/L ♦ Age ≥ 30, total cholesterol > 9.0 mmol/L	Pinpoints individuals at highest risk of FH for further evaluation
Diagnostic Steps if FH suspected	♦ Two LDL measurements ♦ Clinical signs assessment ♦ Rule out secondary hypercholesterolemia ♦ Use Simon Broome or Dutch Lipid Clinic Network criteria	Comprehensive evaluation for accurate diagnosis
Referral	All clinically diagnosed FH patients	Enables specialist confirmation and cascade testing
CHD Risk Tools	Not to be used for FH patients	FH patients are already at high risk of premature CHD; regular risk assessment tools are inadequate
High-Risk Adults with heterozygous FH	Managed by a specialist	High risk defined by existing CHD, family history, or ≥2 other cardiovascular risk factors
Other Adults with confirmed heterozygous FH	♦ Lifestyle advice ♦ High-intensity statin or ezetimibe ♦ Consider antihypertensive treatment and aspirin	Aims for >50% LDL reduction; also...

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