Familial hypercholesterolaemia (FH) is the most common inherited metabolic disorder characterized by high cholesterol and if left untreated leads to premature cardiovascular disease, such as heart attacks. Treatment that begins early in life, particularly in childhood, is highly efficacious in preventing cardiovascular disease and cost-effective, thus early detection of FH is crucial. However, in Europe, less than 10% of people living with FH are diagnosed and even less receive life-saving treatment. The Prague Declaration is a call to action for national and European Union policymakers and decision-makers and a result of the Czech EU Presidency meeting on FH Paediatric Screening (early detection of inherited high cholesterol) at the Czech Senate in Prague on 6th September 2022. It builds on a considerable body of evidence which was discussed at the Technical Meeting under the auspices of the Slovenian EU Presidency in October 2021. The Prague meeting addressed the outstanding barriers to the systematic implementation of FH paediatric screening across Europe. In this article, we present the key points from the Prague meeting and concrete actions needed to move forward.

1st Faculty of Medicine Charles University Prague Czech Rep

3rd Department of Internal Medicine General Teaching Hospital Prague Czech Rep

3rd Department of Medicine Department of Endocrinology and Metabolism of the 1st Faculty of Medicine Charles University and General University Hospital Prague Czech Rep

Basque Foundation for Health Innovation and Research Barakaldo Spain

BioISI Biosystems and Integrative Sciences Institute Faculdade de Ciências Universidade de Lisboa Lisboa Portugal

Cardiology Department Hospital Universitario 12 de Octubre Madrid Spain

Cardiovascular Department CCUL CAML Lisbon School of Medicine University of Lisbon Lisbon Portugal

Centre for Cardiovascular Surgery and Transplantation Brno Czech Rep

Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares Madrid Spain

Centro Nacional de Investigaciones Cardiovasculares Madrid Spain

Department of Cardiology Hacettepe University Ankara Turkey

Department of Endocrinology Diabetes and Metabolic Diseases University Children's Hospital University Medical Centre Ljubljana Ljubljana Slovenia

Department of Pediatric Gastroenterology Hepatology and Nutrition Hospices Civil de Lyon HCL Hôpital Femme Mere Enfant HFME Bron France

Department of Prevention and Sports Medicine University Hospital Klinikum rechts der Isar Technical University of Munich Munich Germany

Deutsches Herzzentrum München Munich Germany

Deutsches Zentrum für Herz Kreislauf Forschung Munich Heart Alliance Munich Germany

Diabetes and Endocrine Care Clinique Pediatrique CHL Luxembourg Grand Duchy Luxembourg

Diagnoza FH Libáň Czech Rep

Europan Public Health Alliance Brussels Belgium

European Atherosclerosis Society Göteborg Sweden

European Heart Network European Alliance for Cardiovascular Health Brussels Belgium

Facultad de Medicina Universidad Complutense de Madrid Madrid Spain

Faculty of Medicine University of Ljubljana Ljubljana Slovenia

FH Europe Star House Rochester UK

Global Heart Hub Galway Ireland

Hospital Israelita Albert Einstein Sao Paulo Brazil

Imperial Centre for Cardiovascular Disease Prevention Department of Primary Care and Public Health Imperial College London London UK

Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Rep

Instituto de Investigación Sanitaria Hospital 12 de Octubre Madrid Spain

International Atherosclerosis Society Milan Italy

Laboratory for Vascular Translational Science Paris Cité University Paris France

Laboratory of Biochemistry and Molecular Therapeutics Faculty of Pharmacy Pôle Technologie Santé Saint Joseph University of Beirut Beirut Lebanon

LDL Greece Athens Greece

Lipid Clinic Heart Institute University of Sao Paulo Medical School Hospital Sao Paulo Brazil

Medical Faculty Masaryk University Brno Czech Rep

National Screening Centre Institute of Health Information and Statistics of the Czech Republic Prague Czech Rep

Sorbonne Paris Nord University INSERM Paris France

The Digital Health Society Dublin Ireland

The European Connected Health Alliance Belfast UK

Unidade de 1 and D Grupo de Investigação Cardiovascular Departamento de Promoção da Saúde e Prevenção de Doenças Não Transmissíveis Instituto Nacional de Saúde Doutor Ricardo Jorge Lisboa Portugal

Univ Lyon CarMeN laboratory INSERM U1060 INRAE U1397 Université Claude Bernard Lyon 1 Oullins Lyon France

University Hospital Center Zagreb Department for Metabolic Diseases Zagreb Croatia

University of Amsterdam Department of Paediatrics Amsterdam Netherlands

University Of Cambridge Clinical School Cambridge UK

World Heart Federation Geneva Switzerland

ZEM Solutions Ltd Belgrade Serbia

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