Study shows significant health disparities in treatment of familial hypercholesterolemia

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The Family Heart Foundation, a research and advocacy organization, has shared results from an analysis of its large US familial heart disease database showing that significant disparities exist in the treatment of familial hypercholesterolemia (FH) among racial groups and by income and education levels.

An analysis of real-world data from more than 300 million individuals showed that appropriate lipid-lowering therapy was prescribed more often to people with FH who were white, male, and had higher incomes or higher education, leaving many others insufficiently treated. The findings are being presented at the Nov. 7 American Heart Association Scientific Sessions in Chicago in a poster titled “Using health claims data and machine learning to identify health disparities among individuals with diagnosed and undiagnosed familial hypercholesterolemia.”

“Individuals with FH are at very high risk for premature cardiovascular events and need early and intensive lipid-lowering therapy, but most people are far from receiving adequate care,” said Mary P. McGowan, MD, chief medical officer, Family Heart Foundation and co-author of the study. “These findings highlight the significant unmet need to improve equity and empower all people with FH to reduce cardiovascular risk.”

The observational study included patients diagnosed with CK and those likely to have CK but not yet diagnosed (probable CK). Probable HF patients were identified by the Family Heart Foundation’s validated FIND-FH machine learning model. Filled prescriptions for statins, ezetimibe, and PCSK9i were assessed, as were age, education, income, race/ethnicity, and gender. Among more than 77 million individuals analyzed in this data set, 280,426 had a diagnosis of FH (51% female, 79.5% white, 11.8% black, and 8.7% Hispanic) and 899,027 had probable FH (48% female, 78.7% white, 12.9% black, and 8.5% Hispanic).

Key findings within both diagnosed and probable FH groups:

  • Compared with blacks, whites were 6 to 30% more likely to receive ezetimibe, PCSK9i, or the combination of a statin, ezetimibe, and PCSK9i.
  • Men were 46 to 48% more likely than women to receive high-intensity statins.
  • Individuals with a household income of $100,000 or more were 30 to 50% more likely to receive ezetimibe, PCSK9i, or the combination of a statin, ezetimibe, and PCSK9i than individuals with a household income of less than $49,000.
  • Diagnosed FH patients with a college education were 51% more likely to receive the statin, ezetimibe, and PCSK9i combination than those with a high school education or less.

Data analysis was performed on the Family Heart database, consisting of diagnostic, procedural, and prescription data from claims and/or laboratory information for more than 300 million individuals in the US

About familial hypercholesterolemia

Familial hypercholesterolemia (FH) is a common life-threatening genetic disorder that causes high cholesterol from birth. It is estimated that one in every 250 people has FH. Untreated FH leads to early heart attacks and heart disease. People with FH have high levels of low-density lipoprotein (LDL), or “bad cholesterol,” because of a mutation in one of the genes that control how cholesterol is cleared from the body.

As a result, cholesterol builds up in the blood and can eventually build up in artery walls, which can lead to problems like heart attacks and strokes in young adults and even children. Because FH is genetic, when an individual with FH is diagnosed, it is important that all family members are tested for FH.

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Courtesy of Family Heart Foundation

Quote: Study shows significant health disparities in treatment of familial hypercholesterolemia (2022, Nov. 7) Retrieved Nov. 7, 2022, from family.html

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