Recommendation ID

What is the clinical and cost effectiveness of using different thresholds of LDL‑C concentration in primary care case finding?

Any explanatory notes
(if applicable)

The clinical community recognises that FH is underdiagnosed, with prevalence more likely to be approximately 1 in 250 rather than the widely cited 1 in 500. Searching electronic primary care databases is an effective way of identifying people with FH. One of the ways in which people are identified through electronic primary care database searching is to search using total cholesterol or LDL‑C concentration. Currently, the entire evidence base for identifying cohorts of people with FH through primary care case finding uses a total cholesterol concentration cut-off of 9.3 mmol/l. This is a very high concentration and anecdotal evidence suggests that this identifies older people but may miss younger people with FH. This could lead to missed opportunities to identify and treat people with FH at an earlier age. Research is needed to identify whether using different total cholesterol and LDL‑C concentrations to identify people with FH through primary care database searching affects the diagnostic yield of FH. Additionally, there is a lack of data on the ethnicity, age and triglyceride concentration of people with FH identified through primary care database searching. These should be included as outcomes in future research.

Source guidance details

Comes from guidance
Familial hypercholesterolaemia: identification and management
Date issued
August 2008

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 31/10/2019