As an interventional cardiologist, I often meet patients in the cath lab when prevention is no longer an option—when they are having a heart attack, and a stent or bypass is the only way forward. But what if we could intervene earlier and prevent the need for invasive procedures altogether?

Familial hypercholesterolaemia (FH) is a serious genetic condition that leads to dangerously high cholesterol from birth, dramatically increasing the risk of early heart attacks. It affects 1 in 250 Australians, yet most people with FH remain undiagnosed. Fortunately, FH can often be detected with a simple cholesterol blood test, particularly when LDL cholesterol levels are significantly elevated.

The good news is that cholesterol-lowering treatments are highly effective. Options include statins, ezetimibe, and PCSK9 inhibitors—all of which can substantially reduce cholesterol levels and dramatically lower cardiovascular risk.

Yet, we continue to take a reactive approach, identifying patients only after damage has already occurred. A more proactive strategy—including routine cholesterol screening and early treatment—could shift the focus from treating heart attacks to preventing them entirely.

This means fewer heart attacks, fewer emergency angiograms, and fewer stents.

In an emergency situation, stenting saves lives—but the real victory is stopping the disease before an intervention is ever needed.

When it comes to FH, prevention isn’t just the best strategy—it’s the ultimate intervention.