Key result
Female sex in heterozygous FH is linked to a ~5-year delay in diagnosis and worse LDL-C target attainment.
Why the study?
Are there sex differences in the diagnosis, treatment, and LDL-cholesterol target attainment among Japanese patients with heterozygous familial hypercholesterolemia?
Cohort (n=1,273)
No
Are there sex differences in the diagnosis, treatment, and LDL-cholesterol target attainment among Japanese patients with heterozygous familial hypercholesterolemia?
Answers are grounded in this paper and cite their sources.
Female patients with heterozygous familial hypercholesterolemia face significant delays in diagnosis and are less likely to achieve LDL-C targets compared to males, highlighting a sex bias in clinical care.
Objective: Significant sex differences have been observed in the diagnosis and treatment of familial hypercholesterolemia (FH). This study aimed to clarify sex differences among Japanese FH patients. Methods: We assessed Japanese patients who had been clinically diagnosed with heterozygous FH (HeFH) at our hospital from 1990 to 2022 (n=1,273). We compared variables that were associated with the diagnosis and treatment of HeFH and the attainment rate of low-density lipoprotein (LDL)-cholesterol treatment target between male and female patients. We used the Cox proportional hazards model to assess factors associated with major adverse cardiac events (MACEs) between male and female sexes. Factors associated with MACEs did not significantly differ between male and female. Conclusion: Female patients with HeFH were diagnosed 5 years later than male patients. Moreover, they were less likely to achieve the guideline-recommended LDL-cholesterol level targets. This sex bias represents a significant barrier to clinical care.
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Tada et al. (2026) conducted a cohort in Heterozygous familial hypercholesterolemia (HeFH) (n=1,273). Female sex vs. Male sex was evaluated on Diagnosis timing, LDL-cholesterol treatment target attainment, and major adverse cardiac events (MACEs) (p=<0.001). Female patients with heterozygous familial hypercholesterolemia were diagnosed 5 years later than male patients and were less likely to achieve guideline-recommended LDL-cholesterol targets.
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