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Published on: September 15, 2018
Comorbidities with Familial Hypercholesterolemia (FH): A Systematic Review
Golnaz Vaseghi1, Shaghayegh Haghjooy Javanmard2, Kiyan Heshmat-Ghahdarijani3
1Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Familial hypercholesterolemia (FH) patients commonly have chronic kidney disease (CKD). Other comorbidities like diabetes, hypertension, and cancer show inconsistent or lower prevalence in FH populations compared to the general population.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
- Oncology
Background:
- Familial hypercholesterolemia (FH) is a genetic disorder characterized by high LDL-C levels, increasing cardiovascular disease (CVD) risk.
- Understanding non-cardiovascular comorbidities in heterozygous FH (HeFH) is crucial for comprehensive patient management.
Approach:
- A systematic literature search was conducted across PubMed, Web of Science, and Google Scholar.
- 23 relevant studies were included to analyze comorbidities such as diabetes, CKD, hypertension, and cancer in FH patients.
Key Points:
- FH patients exhibit a higher prevalence of chronic kidney disease (CKD).
- Data on diabetes prevalence in FH patients are inconsistent, with some studies showing higher rates and others lower.
- Hypertension shows a link to FH, but prevalence varies; cancer prevalence appears similar or lower than in the general population.
Conclusions:
- Chronic kidney disease (CKD) is identified as a significant and prevalent comorbidity in the FH population, besides cardiovascular diseases.
- Further research is warranted to clarify the relationship between diabetes and FH, and to investigate cancer prevalence due to limited data and variability.
Abstract:
Familial hypercholesterolemia (FH) is linked to high levels of low-density lipoprotein cholesterol (LDL-C), atherosclerotic, and aortic stenosis to a lesser extent. We looked at the incidence of prevalent comorbid disorders other than cardiovascular disease (CVD), such as diabetes, chronic kidney disease (CKD), hypertension, and cancer in heterozygous FH (HeFH) patients. PubMed, Web of Science, and Google Scholar were searched systematically for studies reporting comorbidities in FH patients. Finally, 23 studies were included after excluding duplicates, papers with unrelated titles, reviews, abstracts, and papers with not sufficient data. Results showed that among the comorbidities that have been studied; FH patients had a greater prevalence of CKD. In terms of diabetes, the data are inconsistent, with some research indicating a higher prevalence of diabetes in FH patients and mostly indicating the opposite. Polymorphism study showed that hypertension has been linked to FH; however, the prevalence of the hypertensive subjects varies among FH groups. In comparison to the general population, cancer was found to have a lower or similar prevalence in FH patients. More research is needed in this area due to the variability of the results of the relationship between diabetes and FH and the small number of studies on cancer. In conclusion only CKD can be considered as an important and prevalent comorbidity in FH population after CVDs.
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