Familial hypercholesterolemia (FH) is associated with a risk of premature coronary heart disease (CHD), and unfortunately, if left untreated, symptoms of CHD manifest already for men in their 40s and about 10 years later in women. Many times these CHD symptoms resolve as fatal myocardial infarctions (MIs) when the men and women are in their 40s and 50s, respectively. This is why it is imperative that we identify individuals with FH and employ aggressive treatment stratagems to lower these patients’ low-density lipoprotein (LDL) cholesterol levels. At this time, for ethical reasons we do not have any prospective, randomized, placebo-controlled clinical trials enrolling sufficient numbers of FH patients to be statistically robust, but we do have good observational data as well as angiographic regression trials that do give us compelling evidence that statins can alter the course of the CHD.
J Clin Lipidol. 2011; 5(6).