{"doi":"10.1016/j.ajpc.2022.100393","title":"The burden of severe hypercholesterolemia and familial hypercholesterolemia in a population-based setting in the US","abstract":"Background: Contemporary prevalence, awareness, and control of severe hypercholesterolemia (SH) and familial hypercholesterolemia (FH) and the associated atherosclerotic cardiovascular disease risk in the US are unknown. Method: Using electronic health records, we assessed the burden of SH and FH in Olmsted County, Minnesota, US, between 2004 and 2015. We defined SH as low-density lipoprotein cholesterol (LDL-C) level ≥190 mg/dl without secondary causes of hypercholesterolemia and FH as a Dutch Lipid Clinic Network score ≥6. Controls were age- and sex-matched individuals with LDL-C level <190 mg/dl. Results: The age- and sex-adjusted point and period prevalence (age-recursive method) of SH was 4.44% and 8.95%, respectively; 1 in 21 had FH (∼1:233 adults), and 46.2% had a recorded diagnosis. Guideline recommended targets (LDL-C <100 mg/dl and <70 mg/dl in the primary and secondary prevention settings, respectively) were achieved in 33.1% and 21.2% of SH cases, with less women overall achieving the target than men (18.6% vs. 23.7%, p=0.022). After adjustment for conventional risk factors, the hazard ratio for incident coronary heart disease (CHD) in those with SH was 1.21 (1.05-1.39; p=0.010), in those with SH and a family history of CHD was 2.16 (1.57-2.96; p<0.001) and in those with FH was 4.61 (2.66-7.97; p<0.001). The association of SH with CHD was modified by age (p-interaction = 0.015), such that the risk was greater at younger ages. Conclusions: SH was prevalent and an independent risk factor for incident CHD. Awareness and control were low, highlighting a treatment gap (more prominent in women) that needs to be addressed.","journal":"American Journal of Preventive Cardiology","year":2022,"id":255744,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":20,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7278,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":684141,"name":"Lubna Alhalabi","orcid":null,"position":1,"is_corresponding":false},{"id":759461,"name":"Medhat Farwati","orcid":"0000-0002-9052-9690","position":2,"is_corresponding":false},{"id":704275,"name":"Magdi Zordok","orcid":null,"position":3,"is_corresponding":false},{"id":904034,"name":"Ashwini Bhat","orcid":"0000-0003-2135-8274","position":4,"is_corresponding":false},{"id":315041,"name":"Carin Y. Smith","orcid":"0000-0002-3610-6945","position":5,"is_corresponding":false},{"id":904035,"name":"Christina M. Wood‐Wentz","orcid":"0000-0003-4561-4404","position":6,"is_corresponding":false},{"id":228990,"name":"Kent R. Bailey","orcid":"0000-0001-8968-643X","position":7,"is_corresponding":false},{"id":58250,"name":"Iftikhar J. Kullo","orcid":"0000-0002-6524-3471","position":8,"is_corresponding":false},{"id":683350,"name":"Seyedmohammad Saadatagah","orcid":"0000-0003-4950-8334","position":0,"is_corresponding":true}],"reference_count":44,"raw_metadata":null,"created_at":"2026-07-19T00:25:17.224217Z","pmid":"36204653","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}