| アブストラクト | BACKGROUND: Social deprivation is associated with higher cardiovascular disease (CVD) morbidity and mortality. We examined whether this is also observed in people with Familial Hypercholesterolaemia (FH). METHODS: Subjects with FH and linked secondary care records in Hospital Episode Statistics (HES) were identified from UK Clinical Practice Research Datalink (CPRD) and the Simon Broome (SB) adult FH register. Cox proportional hazards regression estimated hazard ratios (HR) for composite CVD outcomes (first HES outcome of coronary heart disease, myocardial infarction, angina, stroke, transient ischaemic attack, peripheral vascular disease, heart failure, coronary revascularisation interventions (PCI and CABG)) in Index of Multiple Deprivation (IMD) quintiles. RESULTS: We identified 4309 patients with FH in CPRD (1988-2020) and 2956 in the SB register. Both cohorts had considerably fewer subjects in the most deprived compared to the least deprived quintile (60 % lower in CPRD and 52 % lower in SB). In CPRD, the most deprived individuals had higher unadjusted HRs for composite CVD (HR 1.71 [CI 1.22-2.40]), coronary heart disease (HR 1.63 [1.11-2.40]) and mortality (HR 1.58 [1.02-2.47]) compared to the least deprived but these became insignificant after adjusting for age, sex, smoking and alcohol consumption. In the SB register, hazard ratios for composite CVD increased with increasing deprivation quintiles and remained significant after adjustment for age, sex, smoking and alcohol consumption (adjusted HR in quintile 5 vs quintile 1 = 1.83 [1.54-2.17]). CONCLUSIONS: Strikingly fewer individuals with FH are identified from lower socioeconomic groups, though the most deprived FH patients have the highest risk of CVD and mortality. In CPRD, this risk was largely explained by smoking and alcohol consumption, but not in the SB register. More effective strategies to detect FH and optimise risk factor management, are needed in lower socioeconomic groups. |
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| ジャーナル名 | Atherosclerosis |
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| Pubmed追加日 | 2025/3/5 |
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| 投稿者 | Iyen, B; Qureshi, N; Kai, J; Capps, N; Durrington, P N; Cegla, J; Soran, H; Schofield, J; Neil, H A W; Humphries, S E |
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| 組織名 | Centre for Academic Primary Care, School of Medicine, University of Nottingham,;UK. Electronic address: barbara.iyen@nottingham.ac.uk.;UK.;Clinical Biochemistry, The Shrewsbury & Telford Hospital NHS Trust, Princess;Royal Hospital, Telford, UK.;Cardiovascular Research Group, University of Manchester, UK.;Division of Diabetes, Endocrinology and Metabolism, Imperial College London, UK.;Manchester University NHS Foundation Trust, Manchester, UK.;Wolfson College, University of Oxford, UK.;Centre for Cardiovascular Genetics, Institute of Cardiovascular Sciences,;University College London, London, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40037086/ |
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