Current Causes of Death in Familial Hypercholesterolemia
Abstract Background: Familial hypercholesterolemia (FH) is a codominant autosomal disease characterized by high low-density lipoprotein cholesterol (LDLc) and high risk of premature cardiovascular disease (CVD). The molecular bases have been well defined and effective lipid-lowering is possible. This analysis aimed to study the current major causes of death of genetically defined heFH. Methods: Case-control study designed to analyze life-long mortality in a group of heFH and control families. Data of first-degree family members of cases and controls (non-consanguineous cohabitants), including deceased relatives, were collected from a questionnaire and review of medical records. Mortality was compared among heFH, non-heFH, and non-consanguineous family members.Results: We analyzed 813 family members, 26.4% of them, deceased. Among deceased, mean age of death was 69.3 years in heFH, 73.5 years in non-heFH, and 73.2 years in non-consanguineous, differences that were not statistically significant. Among them, CVD cause of death was 59.7% in heFH, 37.7.% in non-heFH, and 37.4% in non-consanguineous (P=0.012). These differences were greater restricting the analyses to parents’ mortality. The hazard ratio of dying from CVD was 3.02 times higher (95% CI, 1.90-4.79) in heFH members in comparison with the other two groups (non-FH and non-consanguineous), who did not differ in their risk.Conclusions: Current CVD mortality in heFH is lower and occurs later than that described in the last century but still higher than in non-FH. This better prognosis in CVD risk is not associated with changes in non-CVD mortality.