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Cardiovascular disease mortality in familial forms of hypertriglyceridemia: A 20-year prospective study
M A Austin1, B McKnight, K L Edwards
1Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle 98195-7236, USA. maustin@u.washington.edu
Insights
Relatives in familial combined hyperlipidemia (FCHL) families face higher cardiovascular disease (CVD) mortality risk. High triglyceride levels predict CVD death in familial hypertriglyceridemia (FHTG) families, highlighting the need for prevention.
Area of Science:
- Cardiovascular epidemiology
- Lipid metabolism disorders
- Genetic predisposition to cardiovascular disease
Background:
- Familial combined hyperlipidemia (FCHL) and familial hypertriglyceridemia (FHTG) are common inherited lipid disorders.
- Limited prospective data exists on cardiovascular disease (CVD) risk within these families.
- Understanding long-term mortality risks is crucial for targeted interventions.
Purpose of the Study:
- To estimate 20-year total and CVD mortality risk in relatives of FCHL and FHTG probands.
- To assess plasma triglyceride levels as a predictor of mortality in these familial hyperlipidemia cohorts.
- To inform the development of effective CVD prevention strategies.
Main Methods:
- Prospective cohort study utilizing lipid and medical history data from 101 families.
- Vital status and cause of death ascertained for 685 family members (relatives and spouse controls) from 1993-1997.
- Statistical analysis adjusted for baseline covariates to determine relative risks.
Main Results:
- A 1.7-fold increased 20-year CVD mortality risk was observed in siblings and offspring of FCHL families (P=0.02).
- No statistically significant increase in CVD mortality risk was found for FHTG families (RR=1.7, P=0.39).
- Elevated baseline triglyceride levels predicted CVD mortality in FHTG families (RR=2.7, P=0.02), independent of total cholesterol.
Conclusions:
- Relatives in FCHL families exhibit a significantly elevated risk of CVD mortality.
- Baseline triglyceride levels are a significant predictor of CVD mortality in FHTG families.
- These findings underscore the importance of hypertriglyceridemia as a CVD risk factor and the need for preventative measures.
Background:
Familial combined hyperlipidemia (FCHL) and familial hypertriglyceridemia (FHTG) are 2 of the most common familial forms of hyperlipidemia. There is a paucity of prospective data concerning the risk of cardiovascular disease (CVD) in such families. The purposes of this study were to estimate 20-year total and CVD mortality risk among relatives in these families and to evaluate plasma triglyceride as a predictor of death.
Methods And Results:
The study was based on lipid and medical history data from 101 families ascertained in 2 studies conducted in the early 1970s. Vital status and cause of death was determined during 1993 to 1997 for 685 family members, including first-degree relatives of the probands and spouse control subjects. Compared with spouse control subjects, 20-year CVD mortality risk was increased among siblings and offspring in FCHL (relative risk 1.7, P=0.02) after adjustment for baseline covariates. In FHTG families, the relative risk was also 1.7 but was not statistically significant (P=0.39). Baseline triglyceride was associated with increased CVD mortality risk independent of total cholesterol among relatives in FHTG families (relative risk 2.7, P=0.02) but not in FCHL families (relative risk 1.5, P=0.16) after adjustment for baseline covariates.
Conclusions:
This prospective study establishes that relatives in FCHL families are at increased risk for CVD mortality and illustrates the need for effective prevention strategies in this group. Baseline triglyceride level predicted subsequent CVD mortality among relatives in FHTG families, adding to the growing evidence for the importance of hypertriglyceridemia as a risk factor for CVD.
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