What is the highest category of CHD risk in patients with familial hypercholesterolemia (FH)?

Updated: Oct 04, 2021
  • Author: Mose July, MD, CCD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

The highest category of risk includes CHD and CHD risk equivalents include the following:

  • Clinical CHD

  • Symptomatic carotid artery disease (transient ischemic attack or stroke of carotid origin)

  • Peripheral artery disease

  • Abdominal aortic aneurysm

  • Diabetes

  • 10-year risk less than 20%

The LDLc goal for high-risk patients is less than 100 mg/dL and the 10-year risk is greater than 20%. In addition to lifestyle changes, institution of medication is recommended if LDLc level is greater than 100 mg/dL. Patients at high or very high risk have an optional LDLc goal of less than 70 mg/dL.

Patients with cardiovascular disease who are at very high risk have an optional LDLc goal of less than 70 mg/dL.


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