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Familial hypercholesterolemia in patients with hypertension: the China H-type Hypertension Registry Study

Tianzhou Shen1, Renfei Luo1, Hongdong Jiang2

  • 1Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.

Lipids in Health and Disease
|March 27, 2025
PubMed

Insights

Familial hypercholesterolemia (FH) is common in rural hypertensive patients, yet undertreated. Improved awareness and treatment are crucial for managing atherosclerotic cardiovascular disease (ASCVD) risk.

Area of Science:

  • Cardiology
  • Genetics
  • Public Health

Background:

  • Familial hypercholesterolemia (FH) significantly increases atherosclerotic cardiovascular disease (ASCVD) risk.
  • Hypertension is a common comorbidity, potentially exacerbating cardiovascular risk in FH patients.
  • Understanding FH prevalence in specific populations, like rural hypertensives, is vital for targeted interventions.

Purpose of the Study:

  • To determine the prevalence and clinical characteristics of FH in a rural Chinese hypertensive population.
  • To assess the management and LDL-C reduction in FH patients within this cohort.
  • To evaluate ASCVD risk factors and outcomes in hypertensive individuals with and without FH.

Main Methods:

  • A prospective observational cohort study (China H-type Hypertension Registry Study) enrolled 14,234 rural hypertensive participants.
  • FH was diagnosed using the Chinese-modified Dutch Lipid Clinic Network (C-DLCN) criteria.
  • Data on demographics, clinical characteristics, lipid-lowering therapy, and cardiovascular events were collected over a 4-year follow-up.

Main Results:

  • Among 10,900 analyzed patients, 0.72% had probable or definite FH.
  • Only 35.9% of FH patients received lipid-lowering therapy, and 3.6% achieved LDL-C targets.
  • Despite higher baseline ASCVD risk, no significant difference in stroke or CVD event rates was observed between FH and non-FH groups after 4 years.

Conclusions:

  • A significant gap exists between FH prevalence and treatment rates in rural hypertensive populations.
  • Enhanced FH awareness and management are necessary, particularly in individuals with co-existing risk factors.
  • Further research is needed to optimize ASCVD risk reduction strategies for FH patients in primary care settings.
Abstract

Keywords:
Coronary artery diseaseFamilial hypercholesterolemiaHypertensionScreeningStatin

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