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Identification and Treatment of Women with Familial Hypercholesterolemia

  • Women and Cardiovascular Disease (J Robinson, Section Editor)
  • Published:
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Abstract

Women with genetic hypercholesterolemias, including familial hypercholesterolemia (FH), are at greatly increased lifetime risk of cardiovascular disease. All women with low-density lipoprotein cholesterol (LDL-C) ≥190 mg/dL after a trial of lifestyle therapy should receive statin therapy. Aggressive risk factor control and complete avoidance of tobacco exposure are required in order to minimize the excess risk conferred by hypercholesterolemia. Most women with FH require high-intensity statin therapy to achieve a >50% LDL-C reduction for long-term prevention of cardiovascular events. Before starting statins, fibrates, niacin, or ezetimibe, women with FH should be counseled on the potential for birth defects and to discontinue these drugs at least 1–2 months prior to stopping contraception. Cholesterol-lowering drugs can be resumed once pregnancy and lactation are completed. All women should have a fasting lipid panel performed by age 20 years. The children and other first-degree relatives of women with LDL-C ≥190 mg/dL should be screened for FH.

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Disclosure

J.G. Robinson is a board member (unpaid) of the National Lipid Association, and in the past year she has received grants (payable to her institution) from Abbott, Daiichi-Sankyo, Esperion, GlaxoSmithKline, and Merck.

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  1. Departments of Epidemiology & Medicine, Prevention Intervention Center, University of Iowa, 105 River St S455 CPHB, Iowa City, IA, 52242, USA

    Jennifer G. Robinson

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Correspondence to Jennifer G. Robinson.

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Robinson, J.G. Identification and Treatment of Women with Familial Hypercholesterolemia. Curr Cardiovasc Risk Rep 6, 196–204 (2012). https://doi.org/10.1007/s12170-012-0231-7

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