0:03 FH is also called familial hypercholesterolemia and it is a condition that results from the
0:09 body's inability to clear high cholesterol from the blood. This results in startlingly
0:14 high cholesterol levels.
0:16 So, an ideal cholesterol is less than one hundred and thirty milligrams per deciliter.
0:20 And in FH patients generally we see an LDL cholesterol over a hundred and ninety. Usually
0:26 more like two hundred and twenty. And this very high cholesterol level is like a poison
0:31 to the blood vessels that result in huge accumulation of fatty deposits and cholesterol deposits
0:36 in the arteries that feed the heart and it leads to a much, much greater risk of heart
0:41 attack or stroke.
0:41 FH is a genetic condition. It's passed in families and if one parent has it then every
0:48 child has a fifty percent chance of having FH. If you inherit a bad copy both from the
0:53 mother and a bad copy from the father, that's called homozygous FH and it's actually even
0:57 more serious. If FH has been identified in the family, then every family member should
1:02 be screened.
1:03 The key about FH is that you have high cholesterol from the time you're born. So, over the course
1:08 of a life your blood vessels are exposed to very high levels of cholesterol. And this
1:14 really takes, its toll on the arteries.
1:16 It affects one in five hundred people across the world and it affects everybody about equally.
1:22 It's estimated that there are six hundred thousand patients in the United Stated with
1:25 FH,.
1:25 FH is, diagnosed based on a series of tests. Most importantly, what your blood cholesterol
1:31 level is. And then we augment that information with your family history and some physical
1:36 exam findings that are specific for FH. One of them is called the xanthomas and these
1:40 are cholesterol deposits that often happen in the tendons of the body, particularly around
1:44 the elbows or the Achilles tendons. Or there can also be cholesterol deposits around the
1:48 eyes called xanthelasmas,
1:51 Based on these three factors, we can diagnose with great accuracy people with FH. Very rarely,
1:56 but increasingly commonly, we, we use genetic testing to identify FH patients,
2:01 The future for FH I think is going to be bright, because we're going to be able to identify
2:06 through national screening efforts many more patients with FH and get them on the proper
2:10 therapy. The other thing is the development of new therapies. And in fact several new
2:15 drugs are going to be in front of the FDA in the next six months to a year that might
2:19 potentially be approved that we'll be able to use.
2:21 Stanford has been a center for FH care for over thirty years. We have the familial hypercholesterolemic
2:27 clinic where we specialize in the diagnosis and treatment of people with FH. One of the
2:32 keys things that is involved in that, is really not just taking care of the individual patient
2:36 but also trying to take care of the family members of individual patients. We have a
2:41 full-time genetic counselor in the clinic and we have formed the Stanford Center of
2:46 Inherited Cardiovascular Disease which is meant to bring in an additional layer of expertise
2:51 onto heart conditions that are genetic in nature.
2:55 And we're very lucky at Stanford to have some of the best interventional cardiologists,
2:59 and Stanford for over fifty years has been one of the leading centers for cardiac surgery
3:04 in the country.
3:05 FH is treated very aggressively. We treat patients with FH with medications, principally,
3:11 to lower their cholesterol levels, also with recommendations about diet and exercise. We
3:16 have lots of patients, particularly young female patients, that have had heart attacks
3:22 or strokes at an early age, and it's very important to identify those people early so
3:26 they can start therapy and reduce the risk.