Table 1.

Comparison of various treatment modalities in familial hypercholesterolemia

	Characteristics	Advantages	Disadvantages
Diet	Reduced fat, saturated fatty acids, and cholesterol intake. Consider carbohydrates to compensate the low energy caused by low-fat diet	Need to lower doses of pharmacologic drugs	Lower intake of fat-soluble vitamins, lower levels of HDL, and increase in triglycerides
Drugs	Can decrease LDL and triglycerides, or increase HDL	Effective blood cholesterol control	Drug-specific side effects
Lipid apheresis	For homozygous patients or heterozygous nonresponsive to drug therapy	Rapid LDL decrease to 40%–60% retards the progression of intima-media thickness	Invasiveness, rebound LDL increase, no availability in all centers
Liver transplantation	Treatment of choice for patients who are not responsive to routine pharmacologic treatments	Transfer a rich source of functioning LDL receptors, resolution of the symptoms	Long-term immunosuppression, lack of facility in most centers, restricted donors

Abbreviations: HDL, high-density lipoprotein; LDL, low-density lipoprotein.