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Pablo Corral: Key Take‑Home Messages on Familial Hypercholesterolemia
Pablo Corral/LinkedIn
Apr 23, 2026, 03:18

Pablo Corral: Key Take‑Home Messages on Familial Hypercholesterolemia

Pablo Corral, Pharmacology Professor at FASTA University, Past President of Argentine Lipid Society, shared a post on LinkedIn about a recent article by Zahid Ahmad et al. published in Journal of Clinical Lipidology, adding:

“Update on familial hypercholesterolemia: An expert clinical consensus from the National Lipid Association

  • FH is common (approx.1:311) and systematically underdiagnosed therefore the real problem is not rarity, it is detection
  • Driven by lifelong LDL-C exposure, not a single value therefore risk equals LDL-C multiplied by time
  • Genetics help, but phenotype rules therefore treat based on LDL-C burden, not just mutations

Diagnosis

  • LDL-C ≥190 mg/dL (adults) indicates FH, but confirm clinically
  • Genetic testing: useful for cascade screening, not mandatory
  • Always exclude secondary causes before labeling

Screening

  • Universal pediatric screening (9–11 yrs) is not optional- it’s delayed prevention
  • Cascade screening represents the highest yield strategy (and still underused)

Risk

Standard risk calculators?

Useless in FH consequently they underestimate risk

Risk depends on:

  1. Lifetime LDL exposure
  2. Lp(a)
  3. Family history
  4. Timing of treatment

Treatment (no shortcuts)

Lifelong, early, aggressive

Targets:

  • less than 55 mg/dL (secondary prevention)
  • less than 70 mg/dL (primary prevention)

Start with:

  • High-intensity statin, ezetimibe, PCSK9i / others as needed
  • More than or equal to 50% LDL reduction is the floor, not the goal

Take-home

  • FH is not a lipid disorder.
  • It’s a time-dependent vascular disease.
  • Diagnose early, treat hard, treat forever.”

Title: Update on familial hypercholesterolemia: An expert clinical consensus from the National Lipid Association

Authors: Zahid Ahmad, Anandita Agarwala, Marina Cuchel, P. Barton Duell, Robert A. Hegele, Lisa Hudgins, Allison Jamison, Dinesh Kalra, Amit Khera, Joshua W. Knowles, Iftikhar J. Kullo, Ana Morales, Mark A. Rothstein, Joseph J. Saseen, Daniel E. Soffer, Bruce A. Warden, William S. Weintraub, Lauren Williams, Anne C. Goldberg

Pablo Corral: Key Take‑Home Messages on Familial Hypercholesterolemia

 

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Allison Jamison Amit Khera Ana Morales Anandita Agarwala Anne C. Goldberg Bruce A. Warden Daniel E. Soffer Dinesh Kalra European Atherosclerosis Society Hematology Hemostasis Hemostasis News Hemostasis Today Iftikhar J. Kullo Joseph J. Saseen Joshua W. Knowles Journal of Clinical Lipidology Lauren Williams Lisa Hudgins Marina Cuchel Mark A. Rothstein National Lipid Association P. Barton Duell Pablo Corral Robert A. Hegele William S. Weintraub Zahid Ahmad
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