Sex-Based Disparities in Index Cases of Familial Hypercholesterolemia in Vietnam: A Cross-Sectional Study

Familial hypercholesterolemia (FH) is a substantial contributor to the development of atherosclerotic cardiovascular disease. Therefore, the primary focus of our study was to examine sex-based disparities in clinical signs, atherosclerotic status, lipid profiles, and treatment intensity among patients with FH from Vietnam.

This retrospective cross-sectional report analyzed the clinical profiles of 110 patients with FH from the Vietnam Familial Hypercholesterolemia (VINAFH) registry.

Among these patients, 47 (42.7%) were females, and 48 (43.6%) had mutant FH. Women were diagnosed with FH at a significantly later age than men. However, smoking and clinical signs suggestive of FH were observed more frequently in males than in females. Male patients exhibited a higher prevalence of premature coronary artery disease than females. No significant differences in plasma total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels were observed between sexes. In males, the areas under the curve (AUC) for plasma LDL-C levels were 0.83, with a cut-off value of 6.11 mmol/L (sensitivity, 79.4%; specificity, 89.7%). In females, the AUC for plasma LDL-C levels was 0.72, with a cut-off value of 6.9 mmol/L (sensitivity, 57.1%; specificity, 93.9%). Statins were prescribed to most patients (93.6%), with a higher proportion of men than women receiving high-intensity statin therapy.

Our findings suggested that in Vietnam, FH is diagnosed later in women, whereas men are more likely to smoke and have atherosclerotic cardiovascular disease. Treatment intensity in female patients with FH was lower than that in male patients, despite statin prescription.