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Risk Factors for CVD in Heterozygous FH

J Clin Lipidol; ePub 2018 Nov 7; Akioyamen, et al

Several risk factors are significantly and independently associated with cardiovascular disease (CVD) risk in patients with familial hypercholesterolemia (FH) and should be targeted for modification, a recent study found. Researchers conducted a systematic review and meta-analysis to quantify the association between various CVD risk factors and CVD in FH. Pooled odds ratios (ORs) for selected risk factors with random effects meta-analysis were calculated, with attributable risk estimates derived. Among the details:

  • 27 studies representing 41,831 unique participants and 6,629 CVD events were included.
  • Significant CVD risk factors in FH included age (OR 1.07), male sex (OR 1.95), hypertension (OR 2.11), diabetes (OR 1.95), body mass index (OR 1.04), smoking (OR 1.71), elevated lipoprotein (OR 1.90), low high-density lipoprotein-cholesterol (OR 1.39), and a family history of CVD (OR 1.83).
  • Smoking, hypertension, and diabetes accounted for more than a quarter of CVD risk in individuals with FH.
  • A low-density lipoprotein cholesterol (LDL-C) >4.0 mmol/L was associated with 1 in 3 CVD cases.


Akioyamen LE, Genest J, Chu A, Inibhuni H, Ko DT, Tu JV. Risk factors for cardiovascular disease in heterozygous familial hypercholesterolemia: A systematic review and meta-analysis. [Published online ahead of print November 7, 2018]. J Clin Lipidol. doi:10.1016/j.jacl.2018.10.012.