Incidence of cardiovascular events and changes in the estimated risk and treatment of familial hypercholesterolemia: the SAFEHEART registry

Isla, Leopoldo Pérez de; Arroyo-Olivares, Raquel; Alonso, Rodrigo; Muñiz-Grijalvo, Ovidio; Díaz‐Díaz, José Luis; Zambón, Daniel; Fuentes, Francisco; Mata, Nelva; Piedecausa, Mar; Mañas, M. D.; Muñoz-Torrero, Juan Francisco Sánchez; Miramontes-González, José Pablo; Andrés, Raimundo de; Mauri, Marta; Aguado, Rocío; Brea, Ángel; Vidal-Pardo, José I.; Martínez-Faedo, Ceferino; Barba, Miguel Ángel Elvira; Argüeso, Rosa; Ruiz-Pérez, Enrique; Michán, Alfredo; Arrieta, Francisco; Fernández, María Riestra; Pérez, Leire; Díaz-Soto, Gonzalo; Pintó, Xavier; Padró, Teresa; Badimón, Lina; Mata, Pedro; Pérez-Corral, Begoña; Almagro, Fátima; Arroyo, Raquel; Saltijeral, Adriana; Mosquera, Daniel; Casañas, Marta; Carbayo, J. L. Martin; Cepeda, José María; Palencia, José Luis Díaz; Diéguez, Marta; Riestra, María; López‐Miranda, José; Galiana, Jesús; García-Cruces, Jesús; Garrido, Juan Antonio; Irigoyen, Luis; Martínez, Pedro Martínez; Suárez, Lorena; Borrallo, Rosa M.; Mediavilla, Juan Diego; Jaén, Fernando; González, Pablo Amaya; Rubio, P.; Miramontes, Pablo; Fernández-Morera, Juan Luís; Muñiz, Ovidio; González, A Rodríguez; Pereyra, Fernando Xavier; Pastor, José Manuel; J, Pinilla; Jiménez, Manuel Jesús Romero; Ruíz, Enrique; Alvarez, Marcus; Sáenz, Pedro Luis Ruiz; Sánchez, Juan F. Plaza; Sanz, C; Vidal, Jose I.

doi:10.1016/j.rec.2019.10.028

Cited by 6 publications

(3 citation statements)

References 21 publications

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“…burden of these patients (5) . In fact, a recent study of the SAFEHEART study (Spanish Familial Hypercholesterolemia Cohort Study) identified BMI increase, tobacco consumption and hypertension as predictive risk factors for the development of CVD in FH patients (6) .…”

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confidence: 99%

Adults with familial hypercholesterolaemia have healthier dietary and lifestyle habits compared with their non-affected relatives: the SAFEHEART study

Arroyo-Olivares

Alonso

Quintana-Navarro

et al. 2019

Public Health Nutr.

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ObjectiveHealthy lifestyle habits are the cornerstone in the management of familial hypercholesterolaemia (FH). Nevertheless, dietary studies on FH-affected populations are scarce. The present study analyses dietary habits, adherence to a Mediterranean diet pattern and physical activity in an adult population with FH and compares them with their non-affected relatives.DesignCross-sectional study.SettingData came from SAFEHEART, a nationwide study in Spain.ParticipantsIndividuals (n 3714) aged ≥18 years with a genetic diagnosis of FH (n2736) and their non-affected relatives (n 978). Food consumption was evaluated using a validated FFQ.ResultsTotal energy intake was lower in FH patients v. non-affected relatives (P<0·005). Percentage of energy from fats was also lower in the FH population (35 % in men, 36 % in women) v. those non-affected (38 % in both sexes, P<0·005), due to the lower consumption of saturated fats (12·1 % in FH patients, 13·2 % in non-affected, P<0·005). Consumption of sugars was lower in FH patients v. non-affected relatives (P<0·05). Consumption of vegetables, fish and skimmed milk was higher in the FH population (P<0·005). Patients with FH showed greater adherence to a Mediterranean diet pattern v. non-affected relatives (P<0·005). Active smoking was lower and moderate physical activity was higher in people with FH, especially women (P<0·005).ConclusionsAdult patients with FH report healthier lifestyles than their non-affected family members. They eat a healthier diet, perform more physical activity and smoke less. However, this patient group’s consumption of saturated fats and sugars still exceeds guidelines.

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confidence: 99%

Adults with familial hypercholesterolaemia have healthier dietary and lifestyle habits compared with their non-affected relatives: the SAFEHEART study

Arroyo-Olivares

Alonso

Quintana-Navarro

et al. 2019

Public Health Nutr.

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“…The incidence rate of AVR was 4.36 times higher in patients with FH than in nonaffected relatives. In addition, the average incidence of AVR in patients with FH was 1.7 cases for 1000 patients-year compared with a corresponding incidence of 7.7-fold for ASCVD [32]. We showed that AS in FH was associated with sustained elevation in LDL-C levels, age, hypertension and elevated Lp(a) [8 ▪▪ ,33].…”

Section: Predictors Of Severe Aortic Valve Disease In Familial Hyperc...mentioning

confidence: 70%

Dyslipidemia and aortic valve disease

Mata¹,

Alonso

Isla

et al. 2021

Current Opinion in Lipidology

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Purpose of review Degenerative aortic stenosis (AS) is one of the most prevalent heart valve diseases in the adult population. The understanding of AS pathophysiology and involved risk factors have recently undergone a great advance, with low-density lipoprotein cholesterol (LDL-C), lipoprotein (a) [Lp(a)] and other clinical conditions taking on a relevant role. Although little is known about the prevention of AS, we can progressively find more evidence of the possible use of drugs to control risk factors as tools that may delay the progression to severe AS and aortic valve replacement. Recent findings Several factors have shown to be solid predictors of the development of AS. Mendelian randomization and observational studies on risk factors specifically lipid factors, such as hypercholesterolemia, Lp(a), proprotein convertase subtilisin/kexin type 9 and hypertension have provided meaningful new information. The SAFEHEART study has significantly contributed to define the role of LDL-C and Lp(a) in AS. Summary In this review we discuss the interrelationship of dyslipidemia, especially hypercholesterolemia and Lp(a) in the development and prognosis of valvular AS. New imaging tools may contribute to its early detection. Future studies with proprotein convertase subtilisin/kexin type 9 inhibitors and specific therapies to lower Lp(a) might contribute to delay AS development.

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“…In the baseline, only 43% of the treated population was receiving high-dose statins, 26% combination therapy, and 0.4% PCSK9 inhibitors. Even after doctors were made aware, 64% of the population was still only on high-dose statins, without always reaching the LDL goal [27].…”

Section: Discussionmentioning

confidence: 99%

Familial Hypercholesterolemia in the Elderly: An Analysis of Clinical Profile and Atherosclerotic Cardiovascular Disease Burden from the Hellas-FH Registry

Antza,

Rizos,

Kotsis

et al. 2024

Biomedicines

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Background: Familial hypercholesterolemia (FH) carries a high risk of atherosclerotic cardiovascular disease (ASCVD). As the population ages, the age-related influence on clinical characteristics and outcomes becomes increasingly pertinent. This cross-sectional analysis from the HELLAS-FH registry aims to explore potential differences in clinical characteristics, treatment, ASCVD, and goal achievement between those younger and older than 65 years with FH. Results: A total of 2273 adults with heterozygous FH (51.4% males) were studied. Elderly FH patients (n = 349) had a higher prevalence of ASCVD risk factors, such as hypertension (52.1% vs. 20.9%, p < 0.05) and type 2 diabetes (16.9% vs. 6.0%, p < 0.05), compared to younger patients (n = 1924). They also had a higher prevalence of established ASCVD (38.4% vs. 23.1%, p < 0.001), particularly CAD (33.0% vs. 20.2%, p < 0.001), even after adjusting for major ASCVD risk factors. Elderly patients were more frequently and intensively receiving lipid-lowering treatment than younger ones. Although post-treatment LDL-C levels were lower in elderly than younger patients (125 vs. 146 mg/dL, p < 0.05), both groups had similar attainment of the LDL-C target (3.7% vs. 3.0%). Conclusions: Elderly FH patients have a higher prevalence of ASCVD, particularly CAD. Despite more aggressive treatment, the achievement of LDL-C targets remains very poor. These results emphasize the importance of early FH diagnosis and treatment in reducing ASCVD.

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Incidence of cardiovascular events and changes in the estimated risk and treatment of familial hypercholesterolemia: the SAFEHEART registry

Cited by 6 publications

References 21 publications

Adults with familial hypercholesterolaemia have healthier dietary and lifestyle habits compared with their non-affected relatives: the SAFEHEART study

Adults with familial hypercholesterolaemia have healthier dietary and lifestyle habits compared with their non-affected relatives: the SAFEHEART study

Dyslipidemia and aortic valve disease

Familial Hypercholesterolemia in the Elderly: An Analysis of Clinical Profile and Atherosclerotic Cardiovascular Disease Burden from the Hellas-FH Registry

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