Toward an Integrated Therapeutic Approach for Familial Hypercholesterolemia

Abstract

Familial hypercholesterolemia (FH) is a heritable condition that disrupts the body’s ability to clear low-density lipoprotein cholesterol (LDL-C), commonly known as “bad cholesterol” from the bloodstream. This leads to persistently elevated LDL levels from birth, significantly increasing the risk of premature atherosclerosis and cardiovascular events, such as heart attack and stroke. This occurs due to variations in genes such as low-density lipoprotein receptor (LDLR), apolipoprotein B (APOB), and proprotein convertase subtilisin/kexin type 9 (PCSK9). The treatments that are available for FH include pharmacological interventions, microbiome-based treatments, molecular approaches, nanotechnology methods, surgical procedures, nutraceuticals, herbal therapy, yoga and physical fitness methods, along with lifestyle management. This review discusses the adverse effects associated with various conventional treatment methods for hypercholesterolemia and the need for a safe and effective approach for the treatment of this genetic condition. An integrated approach combining pharmacological, molecular, and lifestyle interventions has emerged as a pragmatic solution. Yoga and fitness-based therapies positively impact lipid profiles, offering non-pharmacological and holistic adjunctive options. This comprehensive approach addresses the multifaceted aspects of FH management, considering genetic factors, socioeconomic considerations, and individualized patient needs.

Keywords

Familial hypercholesterolemia / Statins / PCSK9 inhibitors / Gene therapy / Herbal medicine / Yoga therapy / Integrative medicine / Lipoprotein aphersis

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Funding

Ministry of AYUSH, Government of India(F. No. Ad-35013/4/2022-KPMG-NMCG)

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The Author(s), under exclusive licence to the Huazhong University of Science and Technology

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