A case-historical control study of individuals with serum LDL-c concentrations ¡Ý 6.5 mmol/L; 96 cases receiving an interpretative comment suggesting FH compared with 100 controls not receiving a comment.
Serum LDL-c was repeated in 63 (66 % ) cases and 70 (70 % ) controls within 12 months. LDL-c decreased in 59 (94 % ) cases and in 61 (87 % ) controls. In individuals with a repeat LDL-c, a mean LDL-c reduction of 2.3 mmol/L (32 % ; p < 0.0001) was demonstrated in controls, compared with 3.0 mmol/L (42 % ; p < 0.0001) in cases; significantly greater than that of controls (p < 0.005). Interpretative comments suggesting specialist review were associated with a higher referral rate compared with controls (11.5 % vs 1 % , p < 0.05).
Interpretative commenting was associated with a significant additional LDL-c reduction and increased specialist referrals compared with controls. However, only a minority of individuals received a specialist referral. Interpretative commenting may play an important role in the detection and management of FH.