221 - Characteristics and cardiovascular disease morbidity of men and women with Familial Hypercholesterolaemia (FH): A cohort study using data from the UK Simon Broome register linked with secondary care records (ID 682)
Abstract
Background and Aims
Previous studies of the Simon Broome (SB) FH register reported 3-fold higher cardiovascular disease (CVD) mortality in women vs men in the period 2008-2015. Here we examine CVD morbidity outcomes in these patients.
Methods
The SB subjects (aged 20-79 years), were linked with the UK secondary care Hospital Episode Statistics (HES) database. The excess Standardised Morbidity Ratio (SMbR) compared to an age and sex-matched UK general practice sample was calculated (95% confidence intervals) for risk of composite CVD (first HES outcome of coronary heart disease (CHD), myocardial infarction (MI), stable or unstable angina, stroke, TIA, PVD, heart failure, PCI and CABG).
Results
Of 3,553 SB register subjects 2,988 (52.5% women) had HES records. At registration, men had a significantly (all p<0.01) higher prevalence of hypertension (12.4% vs 7.8%), previous CHD (24.8% vs 17.6%) previous MI (13.2% vs 6.3%), and were commenced on lipid-lowering treatment at a younger age then women (37.5years vs 42.3years). The composite CVD SMbR in men was 6.23 (5.77-6.73), and in women was 6.90 (6.39-7.45). In subjects aged 40-60 the composite SMbR in women was 50% higher than in men (9.24 (8.27-10.33) vs 6.11(5.49-6.79)).
Conclusions
Men with FH have higher prevalence of CVD risk factors than females and appear to be treated earlier and more optimally than women with FH. CVD morbidity due to FH however remains markedly elevated in women, especially those aged 40-60 years. This highlights the need for optimal and timely lipid-lowering risk factor management for men and particularly women with FH.
