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Clinical familial hypercholesterolemia, heart healthy dietary adherence, and cardiovascular risk

Frida Toft-Nielsen1, Frida Emanuelsson2, Børge G Nordestgaard3

  • 1Department of Clinical Biochemistry, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen, 2100, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, 2200, Denmark.

Atherosclerosis
|July 31, 2025
PubMed

Insights

A heart-healthy diet lowers harmful lipids and reduces cardiovascular risk in familial hypercholesterolemia (FH) patients, even when on medication. Emphasizing diet alongside medication is key for managing FH.

Area of Science:

  • Cardiology
  • Nutritional Science
  • Genetics

Background:

  • Familial hypercholesterolemia (FH) significantly elevates the risk of premature cardiovascular disease.
  • Lifestyle interventions and lipid-lowering medications are crucial for risk reduction in FH patients.

Purpose of the Study:

  • To investigate whether adherence to a heart-healthy diet offers additional cardiovascular risk reduction in FH patients, independent of lipid-lowering medication.

Main Methods:

  • Utilized Dutch Lipid Clinic Network (DLCN) criteria for FH diagnosis in a large population study.
  • Assessed dietary adherence to Danish/international guidelines and measured various lipid/lipoprotein levels and ischemic heart disease (IHD) risk.

Main Results:

  • Higher heart-healthy dietary adherence correlated with lower levels of LDL cholesterol, apoB, non-HDL cholesterol, remnant cholesterol, and triglycerides.
  • Reduced risk of ischemic heart disease (IHD) was observed with increased dietary adherence, irrespective of FH status or medication use.

Conclusions:

  • Adherence to a heart-healthy diet demonstrably lowers atherogenic lipids and reduces IHD risk in FH individuals.
  • Dietary adherence is a vital supplementary strategy to lipid-lowering medication for managing FH.
Abstract

Keywords:
Cardiovascular diseaseDietary adherenceFamilial hypercholesterolemiaLipidsMyocardial infarctionSex difference

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