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Overweight, obesity, and cardiovascular disease in heterozygous familial hypercholesterolaemia: the EAS FH Studies Collaboration registry

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...

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Main Authors: Elshorbagy, Amany (Author) , Vallejo-Vaz, Antonio J (Author) , Barkas, Fotios (Author) , Lyons, Alexander R M (Author) , Stevens, Christophe A T (Author) , Dharmayat, Kanika I (Author) , Catapano, Alberico L (Author) , Freiberger, Tomas (Author) , Hovingh, G Kees (Author) , Mata, Pedro (Author) , Raal, Frederick J (Author) , Santos, Raul D (Author) , Soran, Handrean (Author) , Watts, Gerald F (Author) , Abifadel, Marianne (Author) , Aguilar-Salinas, Carlos A (Author) , Alhabib, Khalid F (Author) , Alkhnifsawi, Mutaz (Author) , Almahmeed, Wael (Author) , Alnouri, Fahad (Author) , Alonso, Rodrigo (Author) , Al-Rasadi, Khalid (Author) , Al-Sarraf, Ahmad (Author) , Arca, Marcello (Author) , Ashavaid, Tester F (Author) , Averna, Maurizio (Author) , Banach, Maciej (Author) , Becker, Marianne (Author) , Binder, Christoph J (Author) , Bourbon, Mafalda (Author) , Brunham, Liam R (Author) , Chlebus, Krzysztof (Author) , Corral, Pablo (Author) , Cruz, Diogo (Author) , Davletov, Kairat (Author) , Descamps, Olivier S (Author) , Dwiputra, Bambang (Author) , Ezhov, Marat (Author) , Groselj, Urh (Author) , Harada-Shiba, Mariko (Author) , Holven, Kirsten B (Author) , Humphries, Steve E (Author) , Kayikcioglu, Meral (Author) , Khovidhunkit, Weerapan (Author) , Lalic, Katarina (Author) , Latkovskis, Gustavs (Author) , Laufs, Ulrich (Author) , Liberopoulos, Evangelos (Author) , Lima-Martinez, Marcos M (Author) , Maher, Vincent (Author) , Marais, A David (Author) , März, Winfried (Author) , Mirrakhimov, Erkin (Author) , Miserez, André R (Author) , Mitchenko, Olena (Author) , Nawawi, Hapizah (Author) , Nordestgaard, Børge G (Author) , Panayiotou, Andrie G (Author) , Paragh, György (Author) , Petrulioniene, Zaneta (Author) , Pojskic, Belma (Author) , Postadzhiyan, Arman (Author) , Reda, Ashraf (Author) , Reiner, Željko (Author) , Reyes, Ximena (Author) , Sadiq, Fouzia (Author) , Sadoh, Wilson Ehidiamen (Author) , Schunkert, Heribert (Author) , Shek, Aleksandr B (Author) , Stroes, Erik (Author) , Su, Ta-Chen (Author) , Subramaniam, Tavintharan (Author) , Susekov, Andrey V (Author) , Tilney, Myra (Author) , Tomlinson, Brian (Author) , Truong, Thanh Huong (Author) , Tselepis, Alexandros D (Author) , Tybjærg-Hansen, Anne (Author) , Vázquez-Cárdenas, Alejandra (Author) , Viigimaa, Margus (Author) , Vohnout, Branislav (Author) , Yamashita, Shizuya (Author) , Ray, Kausik K. (Author) , Krämer, Bernhard (Author) , Stach-Jablonski, Ksenija (Author)
Format: Article (Journal)
Language:English
Published: 21 March 2025
In: European heart journal
Year: 2025, Volume: 46, Issue: 12, Pages: 1127-1140
ISSN:1522-9645
DOI:10.1093/eurheartj/ehae791
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1093/eurheartj/ehae791
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Author Notes:Amany Elshorbagy, Antonio J. Vallejo-Vaz, Fotios Barkas, Alexander R.M. Lyons, Christophe A.T. Stevens, Kanika I. Dharmayat, Alberico L. Catapano, Tomas Freiberger, G. Kees Hovingh, Pedro Mata, Frederick J. Raal, Raul D. Santos, Handrean Soran, Gerald F. Watts, Marianne Abifadel, Carlos A. Aguilar-Salinas, Khalid F. Alhabib, Mutaz Alkhnifsawi, Wael Almahmeed, Fahad Alnouri, Rodrigo Alonso, Khalid Al-Rasadi, Ahmad Al-Sarraf, Marcello Arca, Tester F. Ashavaid, Maurizio Averna, Maciej Banach, Marianne Becker, Christoph J. Binder, Mafalda Bourbon, Liam R. Brunham, Krzysztof Chlebus, Pablo Corral, Diogo Cruz, Kairat Davletov, Olivier S. Descamps, Bambang Dwiputra, Marat Ezhov, Urh Groselj, Mariko Harada-Shiba, Kirsten B. Holven, Steve E Humphries, Meral Kayikcioglu, Weerapan Khovidhunkit, Katarina Lalic, Gustavs Latkovskis, Ulrich Laufs, Evangelos Liberopoulos, Marcos M. Lima-Martinez, Vincent Maher, A. David Marais, Winfried März, Erkin Mirrakhimov, André R. Miserez, Olena Mitchenko, Hapizah Nawawi, Børge G Nordestgaard, Andrie G. Panayiotou, György Paragh, Zaneta Petrulioniene, Belma Pojskic, Arman Postadzhiyan, Ashraf Reda, Željko Reiner, Ximena Reyes, Fouzia Sadiq, Wilson Ehidiamen Sadoh, Heribert Schunkert, Aleksandr B. Shek, Erik Stroes, Ta-Chen Su, Tavintharan Subramaniam, Andrey V. Susekov, Myra Tilney, Brian Tomlinson, Thanh Huong Truong, Alexandros D. Tselepis, Anne Tybjærg-Hansen, Alejandra Vázquez-Cárdenas, Margus Viigimaa, Branislav Vohnout, Shizuya Yamashita, and Kausik K. Ray, on behalf of the EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)

MARC

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520 |a 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. 
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