Significant gaps in awareness of familial hypercholesterolemia among physicians in selected Asia-Pacific countries: A pilot study

•Familial hypercholesterolemia (FH) is underrecognized, understudied, underdiagnosed, and undertreated in Asia.•Shortfalls in knowledge and awareness of FH in physicians are identified.•Professional interventions are required to close this important gap in cardiovascular disease prevention.•Country-specific models of care are imperative to improve screening, diagnosis, treatment, and care of FH.

BackgroundFamilial hypercholesterolemia (FH) is a dominantly inherited disorder characterized by high plasma cholesterol levels and a very high risk of early heart disease. The prevalence of FH is estimated to be at least 1:500, with at least 3.6 million individuals in the Asia-Pacific region.ObjectiveTo assess awareness, knowledge, and perception of FH among practicing physicians in Japan, South Korea, and Taiwan.MethodsPhysicians from 3 economically developed Asian countries were requested to anonymously complete a structured Internet-based survey regarding FH. This survey sought responses on the clinical description, inheritance, prevalence, cardiovascular disease risk, practices, and opinions on screening.ResultsOf 230 physicians surveyed, 47% were aware of the heritability, 27% of the prevalence, and 13% of the risk of cardiovascular disease relating to FH. The majority (70%) perceived themselves to have an above-moderate familiarity with FH. Primary care physicians (59%) and lipid specialists (41%) were perceived as the best providers for caring for FH, including cascade screening services, with a lesser role perceived for cardiologists, endocrinologists, and no significant role for nursing staff. Only 35% of physicians were aware of specialist clinical services for lipid disorders in their geographic area.ConclusionExtensive education and training programs are required to complement the implementation of region-specific models of care for FH in Asia. Further enhancement of existing lipid services and facilities are also warranted to optimise service models.