Women, Blacks, and Asians Are at Risk FH Patients

HEALTH NEWS

(Photo – thefhfoundation.org).

Despite 50 plus years of research in patients with familial hypercholesterolemia (FH), few prior studies have evaluated health disparities, and none have included multi-ethnic cohorts.

Today, the FH Foundation announced new data published in Atherosclerosis highlighting potential health disparities that contribute to the under-treatment of individuals with familial hypercholesterolemia (FH). After analyzing data from more than 3,000 U.S. adults in the CASCADE FH Registry, the investigators found that women were more under-treated than men, and Asians and Blacks were more under-treated than Whites.

First-line therapy for FH patients is well established to be high-intensity statins, irrespective of age, sex or ethnicity/race. Yet, when compared to men, women were 34% less likely to receive any statin therapy, 40% less likely to be on a high-intensity statin, and 20-30% less likely to achieve adequate LDL-C reduction.

1 in 250 Americans
have FH
…90% of those
are undiagnosed

Blacks were diagnosed with FH at older ages than any other race/ethnicity. Asians and Blacks were 30-50% less likely than Whites to achieve adequate LDL-C reduction.

Zahid Ahmad, MD, assistant professor, UT Southwestern Medical Center, and site principal investigator for the CASCADE FH Registry, said:

These gender and race disparities are alarming, especially since FH is an equal opportunity genetic disorder affecting both sexes and all races and ethnicities. Although our study does not pinpoint the causes of these disparities, it makes us worry that women, Blacks, and Asians are at risk for worse health outcomes. It’s imperative that we improve our understanding of these gaps and continue to educate healthcare professionals about the need for appropriate treatment in all FH patients.

This disparity data mirror broader cardiovascular studies, with women and minorities receiving less guideline-based cardio-protective therapies. Cardiovascular heart disease mortality rates remain substantially higher in blacks than in other U.S. ethnic groups.  Cardiovascular disease is the leading cause of death of American women, and yet, mistakenly, many healthcare providers miss the signs of heart disease, and FH, in women.

Katherine Wilemon, Founder and CEO of the FH Foundation, said:

Individuals with familial hypercholesterolemia are at an extremely high risk for heart disease during the prime of their lives if left untreated, and yet, they continue to be vastly under-diagnosed. The national CASACADE FH Registry demonstrates that women, Blacks and Asians living with FH are treated later and less effectively than their White male counterparts. We need to rigorously study these groups and develop evidence-based strategies to drive improved care for all individuals with this life-threatening genetic condition.

Individuals with FH are already under-diagnosed and under-treated, even though they are at high risk for cardiovascular disease. An estimated 1 in 250 Americans have FH, but 90% of those are undiagnosed. FH is the most common dominantly inherited genetic disorder. FH causes high LDL-C, or bad cholesterol, from birth.  Left untreated, men with FH have a 50% risk for a fatal or nonfatal coronary event by age 50 and women have a 30% risk by age 60.

The FH Foundation, Pasadena based, is a patient-centered research and advocacy nonprofit organization. It’s mission is to save lives by contributing to scientific research that leads to greater understanding and improved diagnosis of familial hypercholesterolemia worldwide.

Source: FH Foundation