Pioneering new clinic predicts children’s chance of heart attacks in later life

Connor and Keira Pickering (front with parents right) were some of the first patients treated by Specialist Nurse Claire Tucson (behind) and Dr Dominic Smith and Dr Deepak Chandrajay (left)Connor and Keira Pickering (front with parents right) were some of the first patients treated by Specialist Nurse Claire Tucson (behind) and Dr Dominic Smith and Dr Deepak Chandrajay (left)
Connor and Keira Pickering (front with parents right) were some of the first patients treated by Specialist Nurse Claire Tucson (behind) and Dr Dominic Smith and Dr Deepak Chandrajay (left) | jpimedia
Children at risk of having a fatal heart attack when they are older are being treated at a first-of-its kind clinic in York Hospital.

The pioneering service tests and treats youngsters for the hereditary condition, familial hypercholesterolemia (FH), which affects one in 250 people and can lead to heart disease in later life.

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After the success of the adults FH clinic, led by Dr Deepak Chandrajay, consultant in chemical pathology and metabolic medicine, and Claire Tuson, familial hypercholesterolaemia specialist nurse, the hospital has now extended the service to include children and adolescents.

Children come to the clinic when the condition is identified in their parents, which means, rather than waiting for symptoms of heart disease in later life, they can begin treatment 30 or 40 years before signs appear.

The specialist team at the clinic: Dr Deepak Chandrajay, consultant in chemical pathology and metabolic medicine, and Claire Tuson, familial hypercholesterolaemia specialist nurseThe specialist team at the clinic: Dr Deepak Chandrajay, consultant in chemical pathology and metabolic medicine, and Claire Tuson, familial hypercholesterolaemia specialist nurse
The specialist team at the clinic: Dr Deepak Chandrajay, consultant in chemical pathology and metabolic medicine, and Claire Tuson, familial hypercholesterolaemia specialist nurse | other

Despite the availability of genetic testing, more than 85 per cent of people with FH in the UK are undiagnosed. The British Heart Foundation estimates that only around 600 children in the UK have been diagnosed with FH of about 56,000 thought to have the condition, meaning that thousands more are not on treatment and remain unaware of their future risk of heart disease.

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Dr Chandrajay said: “The statistics are high for conditions purely due to high cholesterol. Around 50 per cent of men and 30 per cent of women are likely to have a heart attack before the age of 60. The risk is markedly increased in postmenopausal women.

“An untreated 13 year old who has inherited FH gene from both parents (homozygous FH) would be looking at the same type of problems due to high cholesterol as someone in their early 50s.”

Ms Tuson said: “Research has shown that children with FH start to develop a build-up of fatty plaque in their arteries before the age of 10.

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“Once diagnosed, FH is easy to treat so it makes sense to work with families as soon as possible.

“Last year, with the support of Consultant Paediatrician Dr Dominic Smith, we extended gene testing to all children aged 10 years old and over, who have a parent affected with FH.

“Testing children for FH could prevent a fatal heart attack or stroke.

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“The first six children from York and Scarborough that were identified with FH have recently attended our new Yorkshire and Humber joint paediatric clinic for children and their families, which launched at the end of January.”

She added: “It’s a real breakthrough to be able to identify and treat children with FH so early. Alongside dietary and lifestyle advice to maintain a healthy body weight, children can be considered for statin therapy from as young as 10 years old.

“Statin treatment can not only prevent, but potentially reverse the build-up of cholesterol and allow children and young people to live a perfectly healthy life.”

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FH is an inherited disorder of cholesterol and lipid metabolism, caused by an alteration in a single gene where people have higher levels of “bad” cholesterol levels from birth. If left undetected and untreated FH can lead to the early development of heart and circulatory problems.

Kiera Pickering, 12 and her brother Connor, 11, from Scarborough, were two of the first children to attend the clinic.

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