Study On The Detection Rate, Clinical Characteristics And Treatment Status Of Familial Hypercholesterolemia In Chinese Adults

Objectives To investigate the prevalence,clinical characteristics and lipid-lowering medication of familial hypercholesterolemia(FH)among General Chinese adults and CAD patients.Methods Based on the data collected from September 2015 to August 2020 in the Program of Screening and Intervention Subjects with High Risk Cardiovascular Disease,a natiowide general population from 31 provinces in China’s mainland.FH prevalence was estimated by Chinese expert consensus on screening diagnosis of FH,clinical characteristics of FH and use of lipid-lowering medications were demonstrated among Chinese general population and CAD patients.Morever,logistic regression was used to identify risk factors correlate with statin use in FH patients screened among general population.Results 1.Prevalence,clinical characteristics and lipid-lowering medication of familial hypercholesterolemia(FH)among Chinese adults.Overall,1 059 936 participants(aged 35-75)were enrolled in our study,with the mean age of(56.0±9.9)years.Among them,642 493 were female(60.6%)and 421 255 were urban residents(39.7%).1 383 participants were identified as FH patients.The overall FH prevalence was 0.13%or 1 in 769.Female had 2 times higher FH prevalence than male(0.16 vs.0.08%,P<0.001).Prevalence varied by age and peaked among 55-to 64-year olds.For geographical distributions,prevalence ranged from 0.19%in eastern to 0.1 1 in central and to 0.08%in western China(P<0.001).Participants living in urban area had higher prevalence than their rural conterparts(0.18%vs.0.10%,P<0.001).Rates of premature coronary artery disease and premature ischemic stroke in FH patients were 6.4 and 3.1 times higher than non-FH participants,reapectively(8.3%vs.1.3%and 4.4%vs.1.4%,both P<0.001).The rate of FH patients receiving lipid-lowering medication and statins use were significantly higher than non-FH participants(18.1%vs.2.8%and 13.8%vs.1.3%,P<0.001).Among them,the incidence of FH patients receiving high-intensity and moderate-intensity statins treatment were 7.7%and 5.9%,respectively.None of the FH patients achieved guideline recommended LDL-C level(the targeted LDL-C level was<1.8mmol/L and<2.6mmol/L for FH patients with and without atherosclerostic cardiovascular disease).Hypertension(OR=2.33,95%CI1.58-3.46,P<0.001),diabetes millites(OR=1.80,95%CI1.20-2.69,P<0.01)and urban FH patients(OR=1.55,95%CI 1.07-2.24,P<0.05)were more likely to receive statins treatment.2,Prevalence,clinical characteristics and lipid-lowering medication of familial hypercholesterolemia(FH)among CAD patients.Totally,47 712 CAD patients(aged 35-75)were enrolled in our study.The age of the CAD patients was 62.0±8.1 years old,24 187 were female(50.7%)and 22 941 were urban residents(48.1%).Overall,351 CAD patients were identified as FH and the prevalence was 0.74%or 1 in 135.FH prevalence in female patients were 2 folds higher than male patients(1.00%vs.0.46%,P<0.001).For geographical areas,there existed discrepancy in prevalence of FH with 1.13%in eastern,0,58%in central and to 0,43%in western China(P<0.001).Participants living in urban area have higher prevalence compared with rural participants(0.97%vs.0.52%,P<0.001).The incidence of premature CAD in FH patients was higher than in patients non-FH(64.7%vs.48.8%,P<0.001).The incidence of FH patients receiving lipid-lowering medication and statins treatments were significantly higher than non-FH patients(38.5%vs.22.3%and 33.3%vs.13.7%,P both<0.001).Among them,the incidence of FH patients receiving high-intensity and moderate-intensity statins treatment were 22.2%and 10.8%,respectively.None of them achieved the guideline recommended LDL-C level(LDL-C<1.8mmol/L).Conclusions This study showed that FH prevalence among Chinese general population and CAD patients aged 35-75 was 0.13%and 0.74%,respectively.The incidence of premature CAD and premature ischemic stroke in FH patients was significantly higher than non-FH participants.FH patients were seriously undertreated and none of them achieved guideline recommended LDL-C level.For the fact that FH patients have a higher risk of cardiovascular disease,early screening and appropriate lipid-lowering treatment of FH patients are of great significance for the prevention of ASCVD in China.