Genotype-guided diagnosis in familial hypercholesterolemia: population burden and cascade screening

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Purpose of review

In this review, how genetic testing has provided major new insights regarding the population burden of familial hypercholesterolemia (FH) are reviewed. In addition, the role of genetic testing in cascade screening for FH and an updated MEDPED (Make Early Diagnoses to Prevent Early Death in MEDical PEDigrees) algorithm for the clinical diagnosis of FH are presented.

Recent findings

For the first time, recent application of genetic testing for FH in large populations has provided firm estimates of the prevalence of FH (at least one in 220) in the USA. High associated risks of coronary artery disease make FH the most common genetic cause of premature coronary artery disease.


Genetic testing has yielded accurate, new estimates of the population burden of FH. The potential benefits of early diagnosis of FH on a population-wide level have not yet begun to be realized.

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