Although the recently published NICE Guideline on the Identification and Management of Familial Hypercholesterolaemia contains no surprises for those involved in running specialist Lipid Clinics, it is a landmark in establishing the case for a greater recognition of familial hypercholesterolaemia by general practitioners, general physicians, cardiologists and paediatricians and for the need to consolidate and expand Lipid Clinic services and ensure high clinical standards are maintained. Heterozygous familial hypercholesterolaemia (HeFH) affects 1 in 500 people. This represents some 110,000 of the UK population, similar to the number having type 1 diabetes. The great majority are either undetected or have received incorrect advice from a physician with inadequate knowledge of their condition . This is all the more unfortunate because with appropriate treatment the life expectancy in HeFH is now similar to that of the general population  whereas, untreated, men, in particular, experience symptomatic cardiac ischaemia increasingly from their late 20’s. Some 50% of affected men and 15% of women will have died of coronary and aortic root disease before the age of 60 years [3,4].
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