ABSTRACT
To many doctors, the metabolism of lipoproteins and its disorders must appear as a rather new and complex area. This, coupled with the various controversies surrounding clinical trials of lowering plasma cholesterol that have raged over the years between various people who claimed to understand the subject, did little to convince the clinician that it was worthy of his attention. In fact, much of our knowledge of lipoproteins is neither new nor complex. Worse still, the identification and management of many patients has never been in question and sadly they have suffered because of frequently held misconceptions. Not surprisingly, few medical schools have given adequate tuition in the lipoprotein disorders, and because of the small number of clinicians with an interest in them the opportunity for postgraduate education in the subject is small. Few doctors will be aware that familial hypercholesterolaemia is our most common genetic disease, having about the same frequency as insulin-dependent diabetes. It is an entirely genetic condition and has nothing to do with the so-called diet-heart controversy. It is frequently identifiable by simple physical signs and has a high mortality; almost 60% of male heterozygotes die before the age of 60 without treatment.
