Managing familial hypercholesterolemia in elite athletes
28 May 2019

FC Barcelona’s first team doctors Mindaugas Gudelis and Ricard Pruna reviewed a series of cases and carried out a brief clinical analysis of familial hypercholesterolemia in high-performance athletes in an article for the scientific journal Apunts Medicina de L’Esport. This genetic disorder makes the body unable to eliminate LDL cholesterol from the blood, and this causes patients to be at a higher risk of suffering cardiovascular diseases such as angina, cardiac arrest or stroke.

The idea for this recently published work first arose when the club’s medical services detected several cases of elite athletes with this hereditary condition who needed treatment. The article describes two cases in children.

“The medication used to treat this condition, called statins, often have side effects such as muscle pain. However, these side effects are not present in our players”, explains Doctor Gudelis.

Familial hypercholesterolemia is detected through a blood test, which is carried out on all athletes. Depending on the cholesterol levels, the family history is drawn up and a genetic study is performed to confirm the diagnosis and type of familial hypercholesterolemia.

It is vital to convince the players that they should take the medication, despite the possible side effects. As Gudelis highlights, the medication is important because these players have a high risk of suffering from irreversible cardiovascular alterations in the long term.

“As we pointed out in the article, a person with untreated high cholesterol is five times more likely to suffer a cardiovascular disease compared to others with normal levels”, he emphasises.

Give athletes detailed information on the benefits of treatment

Athletes usually stop taking the medication because they feel healthy. To convince them to continue with the prescribed course of action, Gudelis recommends to explain the disease, its risk factors and what can cause it. Given that there are different types of statins, it is also possible to modify the treatment so that the athletes tolerate it better and avoid the side effects.

Another important point to consider is that these muscle side effects can be prevented through load control, although the situation varies according to the sport. It is therefore vital to have a clear goal and to plan training sessions correctly for the player to avoid muscular aches.

It should also be remembered that muscular pain can arise as a response to training load. But this is due to the physiological process of adaptation to loads and allows us to see whether the load has been high or low, or whether it can be increased to attain the objectives being pursued.

The research paper is relevant because there isn’t much published related to this issue, as there are few high-performance athletes with this condition. FC Barcelona’s medical services will continue working to obtain more information and knowledge of familial hypercholesterolemia in high-performance athletes.

Reference to original article (in English): Apunts Med Esport.

The Barça Innovation Hub team


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