Finally, there are 2 negative recommendations, highlighting strategies that should not be applied to FH patients.
The first option to be avoided, according to the FNLA committee recommendations, was use of any risk prediction algorithm. For example, contrary to risk assessment in the general population, the committee strongly advocated never using risk scoring such as the Framingham Risk Score, because every patient with FH should be treated with drug therapy if their serum LDL cholesterol is >190 mg/dL regardless of their 10-year CHD risk. There is no reason for a physician to calculate a risk stratification level, because every FH patient should be prescribed drug therapy, with intensification of therapy based on the presence of CVD or of additional risk factors. J Clin Lipidol. 2011; 5(6).
