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Hypertension and clinical outcomes in patients with familial hypercholesterolemia

Ming-Ming Liu1, Jia Peng, Rui-Xia Xu

  • 1Cardiovascular Metabolic Center, State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Journal of Hypertension
|August 9, 2022
PubMed

Insights

Hypertension independently increases cardiovascular event risk in heterozygous familial hypercholesterolemia (HeFH) patients. Poor blood pressure control further worsens outcomes in these individuals.

Area of Science:

  • Cardiology
  • Genetics
  • Public Health

Background:

  • Hypertension is a known cardiovascular disease risk factor.
  • The specific impact of hypertension on clinical outcomes in heterozygous familial hypercholesterolemia (HeFH) patients remains unclear.
  • This study investigates hypertension's effects on coronary atherosclerosis and cardiovascular events in HeFH.

Purpose of the Study:

  • To determine the association between hypertension and the severity of coronary artery atherosclerosis in HeFH patients.
  • To evaluate the impact of hypertension on cardiovascular outcomes in individuals with HeFH.
  • To assess the role of blood pressure control status on cardiovascular event risk in HeFH.

Main Methods:

  • 480 patients with diagnosed HeFH were categorized into hypertension and normotension groups.
  • Coronary stenosis severity was assessed using number of diseased vessels, Gensini, Syntax, and Jeopardy scores.
  • Cox proportional hazard models were used to analyze the association between hypertension and cardiovascular events (CVEs).

Main Results:

  • Hypertensive HeFH patients exhibited more severe coronary stenosis and a higher incidence of CVEs compared to normotensive patients.
  • Hypertension was associated with a 2.1-fold increased risk of CVEs in HeFH patients after multivariable adjustment.
  • Blood pressure control status was significantly associated with CVEs, even after adjusting for multiple variables.

Conclusions:

  • Hypertension is an independent risk factor for cardiovascular events in patients with HeFH.
  • Blood pressure control status is linked to worse cardiovascular outcomes in hypertensive HeFH patients.
  • No combined effect on increased cardiovascular risks was detected in this HeFH cohort.
Abstract

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