Cascade Screening and Treatment Initiation in Young Adults with Heterozygous Familial Hypercholesterolemia
| Autor: | Dean G. Karalis, Nathan D. Wong, Robert C. Block, Matthew Bang, Amy L. Peterson |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty cascade screening primary prevention Clinical Sciences Cascade screening Familial hypercholesterolemia 030204 cardiovascular system & hematology Cardiovascular High cholesterol Article Coronary artery disease 03 medical and health sciences 0302 clinical medicine Clinical Research 030225 pediatrics cholesterol screening medicine Young adult Family history Pediatric familial hypercholesterolemia business.industry Prevention dyslipidemia General Medicine Health Services medicine.disease Atherosclerosis Heart Disease Good Health and Well Being Medical genetics Medicine atherosclerosis business Dyslipidemia |
| Zdroj: | Journal of clinical medicine, vol 10, iss 14 Journal of Clinical Medicine Volume 10 Issue 14 Journal of Clinical Medicine, Vol 10, Iss 3090, p 3090 (2021) |
| Popis: | Heterozygous familial hypercholesterolemia (HeFH) creates elevated low-density lipoprotein cholesterol (LDL-C), causing premature atherosclerotic cardiovascular disease (ASCVD). Guidelines recommend cascade screening relatives and starting statin therapy at 8–10 years old, but adherence to these recommendations is low. Our purpose was to measure self-reported physician practices for cascade screening and treatment initiation for HeFH using a survey of 500 primary care physicians and 500 cardiologists: 54% “always” cascade screen relatives of an individual with FH, but 68% would screen individuals with “strong family history of high cholesterol or premature ASCVD”, and 74% would screen a child of a patient with HeFH. The most likely age respondents would start statins was 18–29 years, with few willing to prescribe to a pediatric male (17%) or female (14%). Physicians who reported previously diagnosing a patient with HeFH were more likely to prescribe to a pediatric patient with HeFH, either male (OR = 1.34, 95% CI = 0.99–1.81) or female (OR = 1.31, 95% CI = 0.99–1.72). Many physicians do not cascade screen and are less likely to screen individuals with family history of known HeFH compared to “high cholesterol or premature ASCVD”. Most expressed willingness to screen pediatric patients, but few would start treatment at recommended ages. Further education is needed to improve diagnosis and treatment of HeFH. |
| Databáze: | OpenAIRE |
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