Perception of Cardiovascular Risk in Familial Hypercholesterolemia According to Sex

Familial hypercholesterolemia (FH), a common inherited genetic condition, is characterized by elevated LDL-C and premature cardiovascular disease (CVD). Recent data indicate an under-treatment of women with FH, which could be attributed to women having a different perspective of FH compared with men. To characterize the role of sex in the perception of the CVD risk associated with FH. A survey investigating the role of sex in the perception of FH was created and sent to 1073 FH patients at the MUHC and UBC lipid clinics, using a prospective cohort study design. A total of 412 patients (51.9% men) participated in the survey; mean age was 56.2±14.4y. There was a higher proportion of men with CVD than women (41.5% vs. 16.5%, respectively, p<0.001). Analyses of the survey responses showed a statistically significant difference between men and women in their perception of CVD risk, with women thinking that their risk was higher compared with men (Pearson’s chi-square p=0.019). There was a significant difference between primary and secondary prevention patients, with more concern for CVD risk in the secondary prevention group (p<0.001). No sex difference within these two groups was observed. When patients were separated according to median age (58y), the risk of CVD was perceived to be higher in the young patients (p=0.003). Overall, FH patients were concerned about their CVD risk, especially women. Age and a personal history of CVD makes a clear difference in the perception of risk for both men and women with FH.