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Humphries et al report that a practice of 10 000 patients is likely to have around 20 patients with familial hypercholesterolaemia who are at risk of premature coronary heart disease.1 They emphasise the importance of primary care in supporting adherence to lipid lowering treatment and lifestyle advice including exercise. Exercise is highly topical in view of the 2012 London Olympics and two recent UK government initiatives ‘Be active, Be healthy’ and ‘Change4life’.2 For a medical student research project we examined self-reported exercise in cardiovascular and orthopaedic patients at Bedford Hospital. Following ethical review, Manning conducted a questionnaire survey in July 2009.
The response rate was 84% (63/75). Mean age of responders was 71 years (range 27 to 97) and 90% were white. Although 86% reported exercising regularly, only 29% complied with DOH recommendations (30 minutes of moderate exercise five times a week).3 White patients were significantly more likely than those from ethnic minorities to participate in regular exercise (91% 51/56 versus 43% 4/7, P<0.05). Similarly more men than women reported doing the DOH recommended amount of exercise (50% 12/24 men versus 15% 6/39 women P<0.05). Comparable results have been seen in previous studies.4,5
Lack of awareness is a major problem in both exercise promotion and familial hypercholesterolaemia. Only one patient in our study knew how much exercise the DOH recommends. Similarly, it is estimated that 85% of people with familial hypercholesterolaemia remain undiagnosed.1 GPs are often the first point of contact for patients with chronic diseases such as familial hypercholesterolaemia. They may have a vital role both in diagnosis of this important condition and in exercise promotion.