US (MEDPED) Diagnostic Criteria for Familial Hypercholesterolemia (FH)
Why Use
FH is underdiagnosed and carries significant mortality risk from cardiac events. Alternative diagnostic criteria include the Dutch Criteria and the Simon Broome Diagnostic Criteria . Of the three, MEDPED is the only one that does not require genetic testing for diagnosis. The risk factors in each criteria set are similar, and clinical judgment as well as local practice factors (similarity of target population to study population) should be considered.
When to Use
Patients with suspected familial hypercholesterolemia (FH), including those with elevated cholesterol and/or personal or family history of premature cardiac events.
Pearls / Pitfalls
Uses three easily obtainable parameters to diagnose familial hypercholesterolemia.
Advice
Consider lifestyle changes, drug therapy, family testing, and other measures to manage FH if diagnosed.
More Information
US (MEDPED) Diagnostic Criteria cutoff values compared to the general population: Total cholesterol cutpoints in mg/dL (mmol/L) Age (years) First Degree relative with FH Second Degree relative with FH Third Degree relative with FH General Population <20 220 (5.7) 230 (5.9) 240 (6.2) 270 (7) 20-29 240 (6.2) 250 (6.5) 260 (6.7) 290 (7.5) 30-39 270 (7) 280 (7.2) 290 (7.5) 340 (8.8) ≥40 290 (7.5) 300 (7.8) 310 (8) 360 (9.3) Instructions: Select appropriate age in column 1. Select appropriate degree relative with FH (if applicable). If patient's cholesterol is higher than cutoff, MEDPED criteria for FH are met.