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Antonio M. Gotto, Jr, MD, DPhil

JAMA. 2004;292:377-378.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Familial hypercholesterolemia is the genetic model for the role of hypercholesterolemia in the pathology of coronary heart disease (CHD), with a frequency of heterozygous familial hypercholesterolemia of 1 in 500.¹ Most heterozygous familial hypercholesterolemia patients have low-density lipoprotein cholesterol (LDL-C) values that are greater than 190 mg/dL (4.91 mmol/L), and premature heart disease is a usual occurrence.² Therefore, physicians may classify familial hypercholesterolemia patients as being at high coronary risk and may begin preventive efforts as early as childhood, with lifestyle therapy as the foundation of any regimen. A healthful diet, antismoking, and exercise are important messages for all children³; however, because of their genetic predisposition for elevated LDL-C, young persons with familial hypercholesterolemia may require a degree of cholesterol modification that lifestyle measures alone generally cannot provide. In such cases, a more aggressive approach is justified, but the options are limited. The . . . [Full Text of this Article]

Author Affiliation: The Stephen and Suzanne Weiss Dean, Weill Medical College of Cornell University, New York, NY.

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