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Familial hypercholesterolemia and cardiovascular disease in older individuals.
- Source :
-
Atherosclerosis [Atherosclerosis] 2021 Feb; Vol. 318, pp. 32-37. Date of Electronic Publication: 2020 Dec 19. - Publication Year :
- 2021
-
Abstract
- Background and Aims: Familial hypercholesterolemia (FH) is characterized by high LDL-cholesterol (LDL-C) and early atherosclerotic cardiovascular disease (ASCVD). With a lipid lowering therapy (LLT), most individuals with FH may have a longer ASCVD-free survival. However, there is scant data about older individuals with FH.<br />Methods: We compared characteristics of genetically defined FH older individuals with age-matched non-FH counterparts.<br />Results: From 4111 genotyped individuals, 462 older than 60 years were included (198 positive and 264 negative for FH variants). There were no differences regarding median age [%25; 75%] 66.0 (62.0; 71.0) and 66.0 (62.2; 71.0) years, p = 0.68 for FH and non-FH, respectively. In both groups, there was a higher frequency of females, however, there were more males in the FH group 37.4% vs. 24.2%, p = 0.002. No differences were seen between FH and non-FH in LLT use: 88.5% vs. 91.5%, p = 0.29. Despite a longer LLT duration in FH patients (with 11.0 (7.0; 20.0) vs. 7.0 (3.0; 13.0) years, p < 0.001), treatment was started late in both groups: at 54.0 (47.0; 61.0) and 59.0 (52.0; 64.0) years, p < 0.001, in FH and non-FH, respectively. FH had greater frequencies of previous and early ASCVD (40.9% vs. 27.3%, p = 0.002, and 22.2% vs. 9.0%, p < 0.001). In FH, male sex [HR (95%CI)] 2.67 (1.50-4.73), p = 0.001, and LLT onset age 0.96 (0.93-0.99), p = 0.009, were independently associated with ASCVD.<br />Conclusions: Among hypercholesterolemic older individuals participating in a cascade screening program, the genetic diagnosis of FH was associated with higher ASCVD rates, emphasizing the relevance of a monogenic defect as the cause of long-lasting hypercholesterolemia and ASCVD risk, particularly in men.<br /> (Copyright © 2020 Elsevier B.V. All rights reserved.)
- Subjects :
- Aged
Cholesterol, LDL
Female
Humans
Infant
Male
Risk Factors
Cardiovascular Diseases diagnosis
Cardiovascular Diseases epidemiology
Cardiovascular Diseases genetics
Hypercholesterolemia
Hyperlipoproteinemia Type II diagnosis
Hyperlipoproteinemia Type II epidemiology
Hyperlipoproteinemia Type II genetics
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1484
- Volume :
- 318
- Database :
- MEDLINE
- Journal :
- Atherosclerosis
- Publication Type :
- Academic Journal
- Accession number :
- 33450476
- Full Text :
- https://doi.org/10.1016/j.atherosclerosis.2020.12.012