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2168 Circulation December 1, 2015 sufficient evidence for health benefit exists to implement case finding via family history–based screening, cascade screening, or other strategies. Importantly, FH advocacy groups, often led by affected individuals with the support of interested scientists and clinicians, have organized to increase FH awareness and to lobby for an improved focus on FH care needs in individual countries.

Nevertheless, significant challenges to optimizing FH care exist. These include controversy over the value of universal or cascade cholesterol screening for identifying those with FH, lack of prevention research specific to FH distinct from lipid research in the larger community, and lack of integrated case management protocols across the continuum of care for the family with multiple affected members. The Familial Hypercholesterolemia Foundation and the National Lipid Association have proposed