Description
In 2023, the Hungarian Atherosclerosis Society Children"s Section founded PYAAP (Prevention of young adult atherosclerosis in paediatrics), which aims to identify children and adolescents at risk of atherosclerosis, to reduce the risk factors, in order to prevent cardiovascular disease. To this end, national and regional centres have been set up. With regional centres in Northern Hungary, South-West Hungary, West Hungary, East Hungary and South-East Hungary. In the case of a higher cholesterol level detected by a paediatrician, school doctor or general practitioner, the child or adult is referred to the regional lipid centre, which is run by colleagues with lipidology, obesity, hypertension and diabetes licensing exams. At these centres, the cause of the lipid abnormality is precisely defined, and, on this basis, therapy is started, with detailed lifestyle advice. The colleagues working in the centers have a lipidology license exam. Registration of patients with familial hypercholesterolaemia. The Dutch criterion is used to define familial hypercholesterolaemia. Statin is the first-line therapy for cholesterol reduction. If the target value is not reached with statin treatment at the maximum tolerated dose statin + ezetimibe combination recommended. If the statin + ezetimibe combination is not sufficient PCSK9 inhibitor treatment add to the previous lipid lowering therapy. These therapies are available to patients with state subsidies. Among the lipid-lowering drugs, ezetimibe is indicated for patients with cardiovascular disease (ACS, STEMI, non-STEMI), patients with a proven history of cerebrovascular events (TIA, stroke), patients undergoing surgery for peripheral vascular disease, patients at very high cardiovascular risk and with hyperlipidaemia who have received at least 20 mg rosuvastatin or at least 40 mg atorvastatin for 3 months and who have not achieved target LDL levels or have proven intolerance to statin. PCSK9: In a supported indication, it may be prescribed by designated academic centres for the treatment of HoFH or for secondary prevention in patients with LDL levels above 1.8 mmol/l despite 3 months of maximum tolerated dose statin therapy and 1 month of ezetimibe therapy, or in combination with statin and other lipid-lowering therapy. May be confirmed in case of statin intolerance. Bempedoic acid is currently not available in our country. Inclisiran in a supported indication, designated university centers can prescribe for the treatment of HoFH, or for the treatment of secondary prevention patients whose LDL level exceeds of 1.8 mmol/l, despite 3 months of maximum tolerated dose statin treatment and 1 month of ezetimibe treatment with a statin, or a statin and other lipid-lowering therapy combined. Can be proven in case of statin intolerance.Program launch date
2023Responsible entity
N/AAvailable results and quality metrics
It promotes the screening and treatment of early cardiovascular risk factors. Early screening and treatment of FH patients thus reduces cardiovascular complications. The state supports the treatment of very high and high cardiovascular patients with the latest preparations. The government supports the lipid lowering therapy of patients with very high and high cardiovascular risk. The reimbursement of the new expensive lipid lowering therapy by the government.Limitations / comments
Improving the engagement of healthcare personnel involved in screening.