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Familial Hypercholesterolaemia — EECC MCQ

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ModerateHypertension & Preventive CardiologyFamilial HypercholesterolaemiaEECC

A 45-year-old man with a family history of premature CVD has a total cholesterol of 9.8 mmol/L, LDL-cholesterol of 7.2 mmol/L, and tendon xanthomata on examination. What is the most appropriate initial lipid-lowering strategy?

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Correct answer: A — High-intensity statin plus ezetimibe

Explanation lettering: D = shown as A · A = shown as B · B = shown as C · C = shown as D

This patient has clinical familial hypercholesterolaemia. Per the ESC/EAS Dyslipidaemia Guidelines, treatment should be initiated with high-intensity statin, and given the very high baseline LDL-C, ezetimibe should be co-prescribed from the outset. A PCSK9 inhibitor may be added if targets are not met. Lifestyle alone (A) is insufficient. Statin alone (B) is unlikely to achieve target from 7.2 mmol/L. PCSK9 inhibitor monotherapy (D) is not the initial approach. Fibrates (E) are not for isolated LDL-C elevation.

Reference: ESC/EAS (2019/2025): Guidelines for the Management of Dyslipidaemias