If you have FH you have high LDL cholesterol (‘bad’ cholesterol) from birth. Fatty streaks, the first measurable sign of cardiovascular disease may be present by the age of 10.
With early diagnosis and treatment, cardiovascular disease risk can be greatly reduced.
Children over the age of five and adolescents will be offered testing after one of their parents has been diagnosed with FH. There is a 50% chance a child will have FH e.g. if there are 4 children, 2 are likely to have FH. See ‘How is FH inherited?’
Children and adolescents with FH will be referred to a paediatrician in a children’s hospital, if a ‘family’ clinic is not available.
Treatment is individualised for each child and adolescent and takes into account age, family history, presence of other cardiovascular risk factors and the level of LDL cholesterol at diagnosis.
Following a healthy lifestyle should be encouraged from an early age. A healthy lifestyle includes:
- eating a healthy diet (low in saturated and trans fat and with/without plant sterols)
- doing regular physical activity – see Physical activity guidelines for children and adolescents
- being an appropriate weight (doctor will advise on this)
- not smoking
- avoiding alcohol
- maintaining social and emotional health
Making these changes as a family (including taking medication together) will benefit the entire family, including those members who don’t have FH.
Statins are the first choice in medication and can reduce LDL cholesterol levels by up to 60%. Statins are considered after the age of 10 years for both boys and girls. Additional medications are cholesterol absorption inhibitors (Ezetimibe) and bile acid binding resins (compliance for this medication is often poor in children).
- regular blood tests will monitor side effects and adherence to medication
- weight, growth, physical and sexual development and well-being will be checked regularly
- Carotid Ultrasound (CIMT) will measure artery wall (intima-medial) thickness and presence/progression of plaques; this will guide the intensity of treatment. Ultrasounds will be done every 2 years.
Children and adolescents who maintain a healthy lifestyle and take medication from an early age will be able to avoid cardiovascular disease associated with FH and therefore will have a normal life expectancy.
Read a personal story – Putting my child on statins – one parent’s journey
The advice in this website does not replace advice from your GP or healthcare provider.