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Sex-related differences in premature cardiovascular disease in familial hypercholesterolemia

Anandita Agarwala1, Elena Deych2, Laney K Jones3

  • 1Center for Cardiovascular Disease Prevention, Cardiovascular Division, Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, TX, USA.

Journal of Clinical Lipidology
|December 5, 2022
PubMed

Insights

Familial hypercholesterolemia (FH) significantly increases premature atherosclerotic cardiovascular disease (ASCVD) risk in both men and women. Women with premature ASCVD had higher cholesterol levels, indicating a need for aggressive treatment strategies in FH patients.

Area of Science:

  • Cardiology
  • Genetics
  • Public Health

Background:

  • Familial hypercholesterolemia (FH) is linked to increased premature atherosclerotic cardiovascular disease (ASCVD).
  • Limited data exists on sex-specific differences in premature ASCVD and associated risk factors within the FH population.

Purpose of the Study:

  • To evaluate the prevalence and risk factors of premature ASCVD in men and women with FH.
  • To assess sex-specific differences in ASCVD burden and lipid treatment outcomes among FH patients.

Main Methods:

  • Retrospective analysis of 782 individuals with confirmed FH across 5 U.S. clinics.
  • Sex-stratified analysis using generalized linear models to identify predictors of premature ASCVD and lipid treatment outcomes.
  • Covariates included age, sex, diabetes mellitus, hypertension, and smoking status.

Main Results:

  • Premature ASCVD was observed in 35% of men and 18% of women with FH.
  • Women with premature ASCVD exhibited higher mean treated total cholesterol and LDL-C levels compared to men.
  • Analysis identified key predictors for premature ASCVD and treatment outcomes.

Conclusions:

  • High rates of premature ASCVD affect both sexes in FH populations.
  • FH may reduce the typical sex-based disparities in the onset of premature ASCVD.
  • Aggressive prevention and treatment, including addressing non-lipid risk factors and residual hypercholesterolemia, are crucial for FH patients, especially women.
Abstract

Keywords:
Atherosclerotic cardiovascular diseaseDiabetes mellitusFamilial hypercholesterolemiaHypertensionLow-density lipoprotein- cholesterolSex disparitiesSmoking

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