Dietary management of familial hyperlipidaemias

The rising incidence of coronary heart disease (CHD) in affluent populations has focused attention onto predisposing risk factors, among them high blood levels of cholesterol and triglyceride. In some inherited disorders characterized by hyperlipidaemia the risk of developing CHD is extremely high, and attempts at preventing CHD should in the main concentrate on these individuals in view of the magnitude of their risk, although some advice on a prudent diet and life style may be offered to the general population. The lipids in the blood are transported in combination as lipoproteins, and the familial disorders are classified according to which lipoprotein is present in excess. The common inherited disorders predisposing to CHD are familial hypercholesterolaemia (familial hyperbetalipoproteinaemia, Type IIa), familial hypertriglyceridaemia (familial hyperprebetalipoproteinaemia, Type IV), and familial combined hyperlipidaemia (Type IIb). Familial hyperchylomicronaemia (Type I) apparently does not predispose to CHD, and will be considered separately.