Overweight, obesity, and cardiovascular disease in heterozygous familial hypercholesterolaemia: the EAS FH Studies Collaboration registry.
Journal
European heart journal
Journal Volume
46
Journal Issue
12
Start Page
1127
End Page
1140
ISSN
1522-9645
Date Issued
2025-03-24
Author(s)
Elshorbagy, Amany
Vallejo-Vaz, Antonio J
Barkas, Fotios
Lyons, Alexander R M
Stevens, Christophe A T
Dharmayat, Kanika I
Catapano, Alberico L
Freiberger, Tomas
Hovingh, G Kees
Mata, Pedro
Raal, Frederick J
Santos, Raul D
Soran, Handrean
Watts, Gerald F
Abifadel, Marianne
Aguilar-Salinas, Carlos A
Alhabib, Khalid F
Alkhnifsawi, Mutaz
Almahmeed, Wael
Alnouri, Fahad
Alonso, Rodrigo
Al-Rasadi, Khalid
Al-Sarraf, Ahmad
Arca, Marcello
Ashavaid, Tester F
Averna, Maurizio
Banach, Maciej
Becker, Marianne
Binder, Christoph J
Bourbon, Mafalda
Brunham, Liam R
Chlebus, Krzysztof
Corral, Pablo
Cruz, Diogo
Davletov, Kairat
Descamps, Olivier S
Dwiputra, Bambang
Ezhov, Marat
Groselj, Urh
Harada-Shiba, Mariko
Holven, Kirsten B
Humphries, Steve E
Kayikcioglu, Meral
Khovidhunkit, Weerapan
Lalic, Katarina
Latkovskis, Gustavs
Laufs, Ulrich
Liberopoulos, Evangelos
Lima-Martinez, Marcos M
Maher, Vincent
Marais, A David
März, Winfried
Mirrakhimov, Erkin
Miserez, André R
Mitchenko, Olena
Nawawi, Hapizah
Nordestgaard, Børge G
Panayiotou, Andrie G
Paragh, György
Petrulioniene, Zaneta
Pojskic, Belma
Postadzhiyan, Arman
Reda, Ashraf
Reiner, Željko
Reyes, Ximena
Sadiq, Fouzia
Sadoh, Wilson Ehidiamen
Schunkert, Heribert
Shek, Aleksandr B
Stroes, Erik
Subramaniam, Tavintharan
Susekov, Andrey V
Tilney, Myra
Tomlinson, Brian
Truong, Thanh Huong
Tselepis, Alexandros D
Tybjærg-Hansen, Anne
Vázquez-Cárdenas, Alejandra
Viigimaa, Margus
Vohnout, Branislav
Yamashita, Shizuya
Ray, Kausik K
Abstract
Overweight and obesity are modifiable risk factors for atherosclerotic cardiovascular disease (ASCVD) in the general population, but their prevalence in individuals with heterozygous familial hypercholesterolaemia (HeFH) and whether they confer additional risk of ASCVD independent of LDL cholesterol (LDL-C) remains unclear. Cross-sectional analysis was conducted in 35 540 patients with HeFH across 50 countries, in the EAS FH Studies Collaboration registry. Prevalence of World Health Organization-defined body mass index categories was investigated in adults (n = 29 265) and children/adolescents (n = 6275); and their association with prevalent ASCVD. Globally, 52% of adults and 27% of children with HeFH were overweight or obese, with the highest prevalence noted in Northern Africa/Western Asia. A higher overweight/obesity prevalence was found in non-high-income vs. high-income countries. Median age at familial hypercholesterolaemia diagnosis in adults with obesity was 9 years older than in normal weight adults. Obesity was associated with a more atherogenic lipid profile independent of lipid-lowering medication. Prevalence of coronary artery disease increased progressively across body mass index categories in both children and adults. Compared with normal weight, obesity was associated with higher odds of coronary artery disease in children (odds ratio 9.28, 95% confidence interval 1.77-48.77, adjusted for age, sex, lipids, and lipid-lowering medication) and coronary artery disease and stroke in adults (odds ratio 2.35, 95% confidence interval 2.10-2.63 and odds ratio 1.65, 95% confidence interval 1.27-2.14, respectively), but less consistently with peripheral artery disease. Adjusting for diabetes, hypertension and smoking modestly attenuated the associations. Overweight and obesity are common in patients with HeFH and contribute to ASCVD risk from childhood, independent of LDL-C and lipid-lowering medication. Sustained body weight management is needed to reduce the risk of ASCVD in HeFH.
Subjects
Adiposity
Atherosclerosis
Dyslipidaemia
Insulin resistance
SDGs
Type
journal article