Nav: Home

Familial hypercholesterolemia patients at high risk for cardiovascular events

September 17, 2019

PASADENA, Calif., September 17, 2019 - Individuals with familial hypercholesterolemia (FH) were able to lower their cholesterol under FH specialty care, but many are still not meeting LDL-cholesterol targets, according to the FH Foundation's CASCADE FH® Registry. In new research published in the October issue of Atherosclerosis, 52 percent of adults with FH still had LDL-cholesterol over 100 mg/dL despite being on multiple cholesterol-lowering treatments. In addition, these individuals with FH had high heart attack, stroke, and vascular procedure rates, with an annualized cardiovascular event rate of 2.21 per 100 patient years overall, and 4.57 if an individual had a prior cardiovascular event.

"These data from the CASCADE FH Registry demonstrate that individuals with FH are truly a vulnerable, high-risk population for future heart and stroke events, despite being on multiple treatments," said P. Barton Duell, MD, Professor of Medicine, Director, Lipid-Atherosclerosis Laboratory, Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University. "These data suggest that FH patients without known heart disease may actually have a risk of heart attack that is comparable to the risk in patients without FH who have already had a heart attack. Most individuals with FH will require multiple medications to adequately lower the LDL-cholesterol level to below goal. Adding additional medications to achieve an LDL-C level that can help prevent a heart attack, particularly for those who already have heart disease, needs to become the standard of care."

While cardiovascular event rates were high overall, rates of major cardiovascular events were almost six times higher among individuals with prior cardiovascular disease compared to those without. These data underscore the need to treat most patients with FH much more aggressively, possibly with an optimal LDL-C target that may be < 70 mg/dL.

"These five years of data from across the United States underscore the impact of life-long exposure to LDL cholesterol in the FH population," said Katherine Wilemon, Founder and CEO of the FH Foundation. "The vast majority of individuals with FH in the United States continue to live without a diagnosis, barring them from the opportunity to receive appropriate care. Finding these individuals and initiating intensive treatment early in life is critical to preventing heart disease."

The results confirmed very late diagnosis of FH, at age 50 (plus or minus 18 years). Lack of awareness of FH in the public and medical community contributes to low diagnosis rates in the United States.

The results also highlighted the broad number of treatments that are now available for FH and the benefit individuals received by being on multiple therapies. The majority of patients are on three to six treatments to lower their LDL-C. Specifically, the use of high intensity statins and PCSK9 inhibitors, as well as treatment with LDL apheresis, at enrollment were associated with a higher likelihood of reaching LDL-C goals. Individuals who achieved more than a 50 percent reduction in LDL-C took more lipid lowering therapies during follow-up, compared to those who achieved less than a 50 percent reduction.

"Today, there are more safe and effective treatments for individuals with FH. With multiple LDL-C lowering drugs, plant sterols, LDL apheresis and exciting experimental therapies in development, individuals should advocate with their healthcare providers to add treatments until their LDL targets are achieved," added Samuel Gidding, MD, chief medical officer for the FH Foundation.
-end-
About the CASCADE FH® Registry

The CAscade SCreening for Awareness and Detection of Familial Hypercholesterolemia (CASCADE FH) Registry is a national multi-institution observational study that includes the largest cohort of individuals with FH in the United States. FH is a common genetic condition that causes very high cholesterol and can lead to early heart disease if untreated. Only 10 percent of individuals with FH are diagnosed in the United States today. The FH Foundation established and maintains the Registry to increase FH awareness, analyze diagnosis and treatment rates, and monitor clinical outcomes.

About the FH Foundation

The FH Foundation is a leading research and advocacy non-profit organization focused on reducing heart disease by driving scientific understanding and evidence-based care of familial hypercholesterolemia. Our mission is to save lives by contributing to scientific research that leads to greater understanding and improved diagnosis and treatment of FH worldwide.

The Familial Hypercholesterolemia Foundation

Related Heart Disease Articles:

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.
Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.
Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.
Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.
New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.
Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.
Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.
Women once considered low risk for heart disease show evidence of previous heart attack scars
Women who complain about chest pain often are reassured by their doctors that there is no reason to worry because their angiograms show that the women don't have blockages in the major heart arteries, a primary cause of heart attacks in men.
Where you live could determine risk of heart attack, stroke or dying of heart disease
People living in parts of Ontario with better access to preventive health care had lower rates of cardiac events compared to residents of regions with less access, found a new study published in CMAJ (Canadian Medical Association Journal).
Older adults with heart disease can become more independent and heart healthy with physical activity
Improving physical function among older adults with heart disease helps heart health and even the oldest have a better quality of life and greater independence.
More Heart Disease News and Heart Disease Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Our Relationship With Water
We need water to live. But with rising seas and so many lacking clean water – water is in crisis and so are we. This hour, TED speakers explore ideas around restoring our relationship with water. Guests on the show include legal scholar Kelsey Leonard, artist LaToya Ruby Frazier, and community organizer Colette Pichon Battle.
Now Playing: Science for the People

#568 Poker Face Psychology
Anyone who's seen pop culture depictions of poker might think statistics and math is the only way to get ahead. But no, there's psychology too. Author Maria Konnikova took her Ph.D. in psychology to the poker table, and turned out to be good. So good, she went pro in poker, and learned all about her own biases on the way. We're talking about her new book "The Biggest Bluff: How I Learned to Pay Attention, Master Myself, and Win".
Now Playing: Radiolab

Uncounted
First things first: our very own Latif Nasser has an exciting new show on Netflix. He talks to Jad about the hidden forces of the world that connect us all. Then, with an eye on the upcoming election, we take a look back: at two pieces from More Perfect Season 3 about Constitutional amendments that determine who gets to vote. Former Radiolab producer Julia Longoria takes us to Washington, D.C. The capital is at the heart of our democracy, but it's not a state, and it wasn't until the 23rd Amendment that its people got the right to vote for president. But that still left DC without full representation in Congress; D.C. sends a "non-voting delegate" to the House. Julia profiles that delegate, Congresswoman Eleanor Holmes Norton, and her unique approach to fighting for power in a virtually powerless role. Second, Radiolab producer Sarah Qari looks at a current fight to lower the US voting age to 16 that harkens back to the fight for the 26th Amendment in the 1960s. Eighteen-year-olds at the time argued that if they were old enough to be drafted to fight in the War, they were old enough to have a voice in our democracy. But what about today, when even younger Americans are finding themselves at the center of national political debates? Does it mean we should lower the voting age even further? This episode was reported and produced by Julia Longoria and Sarah Qari. Check out Latif Nasser's new Netflix show Connected here. Support Radiolab today at Radiolab.org/donate.