Current Atherosclerosis Reports · 4 authors, 3 centres
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This narrative review summarizes sex differences in familial hypercholesterolemia across the lifespan, finding that girls and women with FH have higher LDL-C levels, later diagnosis, and less intensive treatment than males. The review highlights that young female FH patients may face an excessive atherosclerotic cardiovascular disease risk compared to male FH patients.
This narrative review synthesizes existing literature on sex differences in familial hypercholesterolemia from childhood through adulthood. The review reports that from childhood onward, girls with FH have higher total- and LDL-cholesterol levels than boys, and by age 30 women carry a greater LDL-C burden. In adulthood, women are diagnosed later and receive less lipid-lowering treatment. Regarding cardiovascular outcomes, a Norwegian cohort found mean age at first ASCVD event was 46 years in women and 43 years in men, contrasting with the 7–10 year gap in the general population. In the youngest age groups, a standardized incidence ratio of 13.6 and 7.5 for acute MI was reported for women and men with FH aged 25–39, respectively. Pregnancy and breastfeeding contribute to treatment discontinuation and increased cholesterol burden.
