Suspect
· TC > 7.5 [esp. if personal or Fhx. premature CVD]
· Exclude secondary causes
· DM, Alcohol, Hypothyroidism, nephrotic syndrome, Steroid, Obesity, COC, B Blocker
· Use Simon Broome diagnostic criteria
· Refer possible or definite cases
Simon Broome diagnostic criteria
· Definite
· [Adult [TC > 7.5 or LDL > 4.9]] – [ Children [TC > 6.7 or LDL > 4]] and [tendon xanthomas] or [evidence of these in 1st or 2nd degree relative]
· Possible
· [Adult [TC > 7.5 or LDL > 4.9]] – [ Children [TC > 6.7 or LDL > 4]] and [Fhx MI < 50 in 2nd degree relative or < 60 in 1st degree relative] or [Fhx of high TC > 7.5 in 1st or 2nd degree relative or > 6.7 in child, brother or sister < 16]
Degrees
· 1st – Relatives share half of their genes with the person – [parents, brother, sister, or child]
· 2nd – Relatives shares about one quarter of their genes with the person – [uncle, aunt, nephew, niece, grandparent, grandchild or half-sibling]
· 3rd – Relatives share about one eighth of their genes with the person – [first cousin, great-grandparent or great-grandchild]