Diagnóstico y tratamiento de la hipercolesterolemia familiar en España: Documento de consenso
| Autor: | Mata P., Alonso R., Ruiz A., Gonzalez-Juanatey J.R., Badimón L., Díaz-Díaz J.L., Muñoz M.T., Muñiz O., Galve E., Irigoyen L., Fuentes-Jiménez F., Dalmau J., Pérez-Jiménez F. |
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| Rok vydání: | 2015 |
| Předmět: |
Conference Paper
cholesterol blood level apheresis morbidity genetic analysis Article hydroxymethylglutaryl coenzyme A reductase inhibitor low density lipoprotein cholesterol xanthoma Hyperlipoproteinemia Type II birth Humans human risk reduction long term care algorithm familial hypercholesterolemia cost effectiveness analysis medical specialist screening practice guideline disease association consensus development genetic screening lipoprotein apheresis system heterozygote ischemic heart disease mortality homozygote consensus Spain general practitioner Practice Guidelines as Topic Algorithms ezetimibe |
| Zdroj: | Atencion Primaria r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
| ISSN: | 0212-6567 |
| DOI: | 10.1016/j.aprim.2013.12.015&partnerID=40&md5=5d680ff931d6a64fffc68c156f6fb1e0 |
| Popis: | Familial hypercholesterolemia (FH) is a common genetic disorder, clinically manifested since birth, and associated with very high levels of plasma LDL-cholesterol (LDL-c), xanthomas, and premature coronary heart disease. Its early detection and treatment reduces coronary morbidity and mortality. Despite effective treatment being available, FH is underdiagnosed and under-treated. Identification of index cases and cascade screening using LDL-c levels and genetic testing are the most cost-effective strategies for detecting new cases and starting early treatment. Long-term treatment with statins has decreased the vascular risk to the levels of the general population. LDL-c targets are < 130 mg/dL for children and young adults, < 100 mg/dL for adults, and < 70 mg/dL for adults with known coronary heart disease or diabetes. Most patients do not to reach these goals, and combined treatments with ezetimibe or other drugs may be necessary. When the goals are not achieved with the maximum tolerated drug treatment, a reduction = 50% in LDL-c levels can be acceptable. Lipoprotein apheresis can be useful in homozygous, and in treatment-resistant severe heterozygous, cases. This Consensus Paper gives recommendations on the diagnosis, screening, and treatment of FH in children and adults, and specific advice to specialists and general practitioners with the objective of improving the clinical management of these patients, in order to reduce the high burden of coronary heart disease. © 2013 Elsevier España, S.L.U. All rights reserved. |
| Databáze: | OpenAIRE |
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