1. LDL cholesterol targets rarely achieved in familial hypercholesterolemia patients:A sex and gender-specific analysis
- Author
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Schreuder, M. M., Hamkour, S., Siegers, K. E., Holven, K. B., Johansen, A. K., van de Ree, M. A., Imholz, B., Boersma, E., Louters, L., Bogsrud, M. P., Retterstøl, K., Visseren, F. L.J., Roeters van Lennep, J. E., Koopal, C., Schreuder, M. M., Hamkour, S., Siegers, K. E., Holven, K. B., Johansen, A. K., van de Ree, M. A., Imholz, B., Boersma, E., Louters, L., Bogsrud, M. P., Retterstøl, K., Visseren, F. L.J., Roeters van Lennep, J. E., and Koopal, C.
- Abstract
Background and aims: Despite lipid lowering therapy (LLT), reaching LDL-C targets in patients with familial hypercholesterolemia (FH) remains challenging. Our aim was to determine attainment of LDL-C target levels and reasons for not reaching these in female and male FH patients. Methods: We performed a cross-sectional study of heterozygous FH patients in five hospitals in the Netherlands and Norway. Clinical characteristics and information about LLT, lipid levels and reasons for not being on LDL-C treatment target were retrospectively collected from electronic medical records. Results: We studied 3178 FH patients (53.9% women), median age 48.0 (IQR 34.0–59.9) years. Median LDL-C before treatment and on-treatment was higher in women compared to men (6.2 (IQR 5.1–7.3) and 6.0 (IQR 4.9–7.2) mmol/l (p=0.005) and 3.0 (IQR 2.4–3.8) and 2.8 (IQR 2.3–3.5) mmol/L (p<0.001)), respectively. A minority of women (26.9%) and men (28.9%) reached LDL-C target. In patients with CVD, 17.2% of women and 25.8% of men reached LDL-C target. Women received less often high-intensity statins and ezetimibe. Most common reported reasons for not achieving the LDL-C target were insufficient effect of maximum LLT (women 17.3%, men 24.3%) and side effects (women 15.2%, men 8.6%). Conclusions: In routine practice, only a minority of women and men with FH achieved their LDL-C treatment target. Extra efforts have to be made to provide FH patients with reliable information on the safety of statins and their long-term effects on CVD risk reduction. If statin treatment is insufficient, alternative lipid lowering therapies such as ezetimibe or PCSK9-inhibitors should be considered.
- Published
- 2023