[Familial hypercholesterolemia (FH) is an inherited defect of cholesterol
metabolism characterized by high plasma total cholesterol (TC) and low-density
lipoprotein cholesterol (LDL-C) levels and premature cardiovascular disease
risk. Prevalence of hypertension in FH is not clarified, but its appearance is
independent risk factor for the development of cardiovascular disease. Therefore,
optimal treatment has a major priority in this high-risk population.
We aimed to investigate the lipid parameters and evaluate the presence of
hypertension and its treatment characteristics in 86 newly diagnosed, untreated
heterozygous FH patients (27 males, 59 females, mean age 53.6±13.4 years). We
diagnosed FH by using the Dutch Lipid Clinic Network criteria.
The mean TC level was 8.49±1.7 mmol/l, the mean LDL-C level was 6.11±1.5
mmol/l, the mean high-density lipoprotein cholesterol (HDL-C) level was 1.62±0.5
mmol/l, while the median lipoprotein (a) level was 301 mg/l. We diagnosed 33 FH
patients (38.4%) with hypertension. Beta blockers were used in 23, ACE-inhibitors
in 13, ARBs in 12, calcium channel blockers in 9, and HCT in 11 cases. 11 patients
was treated with monotherapy, for 10 patients double, for 11 patients triple, while
for 1 patient quadruple combined antihypertensive therapy was administered. Based on our results, hypertension might be underdiagnosed in this specific
patient population. Neither the types nor the combination patterns of blood
pressure lowering agents are in line with current guidelines. Up to date screening
and treatment of hypertension should be worth considering in this extremely
high risk population with enhanced atherosclerosis.]
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