DEVELOPMENT OF A PROGRAM FOR IDENTIFICATION OF PATIENTS WITH FAMILIALHYPERCHOLESTEROLEMIA IN BRITISH-COLUMBIA - A MODEL FOR PREVENTION OF CORONARY-DISEASE

We have developed a targeted approach to identification of high-risk p atients in British Columbia, Canada, as an initial strategy for the pr evention of coronary disease. Patients with the diagnosis of familial hypercholesterolemia have been identified through the Lipid Clinic. Fi rst degree relatives of these persons and subsequently identified indi viduals will be screened for the presence of hypercholesterolemia. Usi ng this approach, the likelihood of identifying persons at high risk i s high, close to 50%. The program will also allow collection of data o n factors affecting the expression of hyperlipidemia and atheroscleros is and their response to therapy. In an effort to establish the infras tructure that would be necessary for identification and management of such patients throughout the province, a Lipid Clinic Outreach Program has been developed. The objective is to provide each community in the province with expertise to manage hyperlipidemia without traveling to a major urban area. With this infrastructure in place, this will serv e patients who have premature atherosclerosis due to other causes and will also form the framework for dissemination of heart health policie s and programs by different levels of government, voluntary and profes sional organizations, as well as the private sector. From a targeted f amily centered pilot program, a broad approach to the prevention of co ronary artery disease in this community will be possible.