Press Release WHO/62
4 September 1998
FAMILIAL HYPERCHOLESTEROLAEMIA MUST BE TREATED TO PREVENT CORONARY ARTERY DISEASE
Hypercholesterolaemia is a relatively common condition that has been associated with the development of atherosclerosis and cardiovascular disease. More than half of all deaths in developed countries are related to atherosclerotic cardiovascular diseases, but recent studies have indicated that drug treatment of high-risk individuals can reduce heart attacks by one third and related deaths by nearly 40%. Around twenty specialists participated today in a consultation convened by the World Health Organization (WHO) to begin review selected country progress reports following the conclusions and recommendations adopted at a previous meeting which took place last year in Paris.
It is estimated that more than 10 million people world-wide have familial hypercholesterolaemia. They constitute a unique population at high risk for the premature development of coronary heart disease. Studies conducted prior to the availability of effective cholesterol lowering drugs have indicated that without treatment, the mean age of onset of coronary heart diseases in men with this genetic disorder is around the age of 40 whereas it occurs 10-15 years later in women. The risk of a man with familial hypercholesterolaemia suffering a myocardial infraction is 5% below the age of 30, 50% by the age of 50 and 85% by the age of 60. Corresponding values for women are less than 1% before age 30, 15% by age 50 and 50% by age 60.
At their previous meeting, the specialists noted that the potential to prevent or even reverse atherosclerosis in patients with high level of cholesterol is better now than it has ever been, due to advances in both the recognition and treatment of this disorder. The major challenge for health care providers remains, they stressed, the identification and effective treatment of those patients who currently remain undiagnosed or inadequately treated. They therefore recommended education campaigns to improve public and health care professional awareness of familial cholesterolaemia. They also emphasized the need to establish in all countries a registry of patients suffering of this disorder, of their affected and at risk relatives and of the associated physicians, in order to assist in case detection through family screening, education of patients and their physicians, and long term follow-up. Because of their extreme risk, the patients with familial hypercholesterolaemia should be contacted at least annually to insure their continued treatment and compliance, they noted.
The consultation organized by WHO today reviewed the familial hypercholersterolaemia control activities in various countries including Austria, Brazil, Canada, the Czech Republic, Denmark, France, Germany, Hong Kong (China), Hungary, Israel, Lebanon, Netherlands, Norway, Poland, Singapore, South Africa, Switzerland, the United Kingdom, and the United States of America. As was pointed out at the European Congress of Cardiology meeting in Vienna last month, cholesterol levels are still too high practically in all populations. This shows how urgent it is to treat persons such as those with familial hypercholesterolaemia, whose genetic disorder is well understood, deadly without treatment and well controlled with a treatment which is widely available throughout the world.
The participants mourned the tragic death of Dr Roger Williams, of the University of Utah Cardiovascular Genetics Research Clinics, who had been proposed to chair the meeting but who was killed in the accident of the New York-Geneva Swissair flight on 3 September 1998.
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