Familial hypercholesterolemia
Alternative names:
hypercholesterolemic xanthomatosis; type II hyperlipoproteinemia
Treatment:
The goal of treatment is to reduce the risk of atherosclerotic heart disease and resulting myocardial infarction (heart attack).
Diet modification is the initial phase of treatment and is tried for several months before drug therapy is added. Diet modifications include reducing total fat intake to 30% of the total calories consumed. Saturated fat intake is reduced by decreasing the amounts of beef, pork, and lamb; substituting low-fat dairy products; and eliminating coconut and palm oil. Cholesterol intake is reduced by eliminating egg yolks and organ meats. Further reductions in the percentage of fat in the diet may be recommended after the initial trial period. Dietary counseling is often recommended to assist people with these adjustments to their eating habits.
Exercise, especially to induce weight loss, may also aid in lowering cholesterol levels.
Drug therapy may be initiated if diet, exercise, and weight reduction efforts have not reduced the cholesterol levels after an adequate trial period. Various cholesterol-reducing agents are available including: - bile acid sequestrant resins (cholestyramine and colestipol)
- nicotinic acid
- lovastatin
- gemfibrozil
- probucol
Expectations (prognosis):
The outcome is likely to be poor in people with the homozygote type of familial hypercholesterolemia because it tends to be resistant to treatment.
The outcome of other types of familial hypercholesterolemia depends in part on the patient's compliance with treatment, but reduction in serum cholesterol levels can be achieved and may be significant in delaying a heart attack.
Complications:
Calling your health care provider:
Call your health care provider or go to the emergency room if you have crushing chest pain or other warning signs of myocardial infarction.
Call for an appointment with your health care provider if you or family members are found to have elevated total cholesterol levels.
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