Familial hypercholesterolaemia runs in families and can cause heart attacks silently, often before age 50. This is the scoring tool doctors use to catch it — the Dutch Lipid Clinical Network (DLCN) criteria.
Select the highest-scoring item that applies. Only one item from this section counts.
Select the highest-scoring item that applies. Only one item from this section counts.
Select the highest-scoring item that applies. Only one item from this section counts.
Select the patient's pre-treatment LDL-C level. Only one item counts.
FH is one of the most common inherited genetic conditions, affecting approximately 1 in 250 Australians. It means your body can't clear LDL cholesterol properly from birth — not because of diet or lifestyle, but because of how your genes work. Left untreated, it significantly raises the risk of premature coronary artery disease and heart attack, often in your 40s or 50s.
FH is caused by mutations in genes that affect how the body processes LDL cholesterol — most commonly the LDLR, APOB, or PCSK9 genes. People with FH often have LDL-C levels 2–3 times higher than normal despite a healthy lifestyle.
The upside: caught early, treatment with statins and other lipid-lowering therapies can reduce cardiovascular risk to near-normal levels. Cascade screening of family members is recommended when a case is identified.
The Dutch Lipid Clinical Network (DLCN) Score is the most widely used clinical tool for diagnosing FH. It was developed by the Dutch Lipid Clinic Network and is recommended by the Australasian FH Registry, the European Atherosclerosis Society, and many international guidelines.
The score combines five domains: family history, clinical history, physical examination findings, LDL cholesterol levels, and genetic testing results. Only the highest-scoring item in each domain is counted.
Interpretation:
Score < 3: FH unlikely
Score 3–5: FH possible
Score 6–8: FH probable
Score > 8: FH definite (clinical diagnosis)
A score of ≥ 6 warrants referral for genetic testing and specialist lipid management. A score of 3–5 should prompt further investigation and family screening.
FH Australasia Registry: athero.org.au/fh — register patients and access cascade screening tools.
Cardiac Society of Australia and NZ: Clinical guidelines for FH management.
FH Australia patient resources: fhaustralia.org — patient support and information.
PBS access: Patients with confirmed FH may be eligible for PBS-subsidised PCSK9 inhibitors (evolocumab, alirocumab) through specialist prescription.
Enter the points scored from all other domains (family history + clinical history + physical signs + DNA). The table shows what each LDL result would mean for the final diagnosis.
| LDL-C (mmol/L) | LDL pts | Total | Diagnosis |
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