{"id":"a9d7f27cc1c6","type":"article","url":"https://hartvaat.nl/2026/04/01/risicofactoren-voor-cardiovasculaire-events-bij-heterozygote-familiaire-hypercho/","title":"Risicofactoren voor cardiovasculaire events bij heterozygote familiaire hypercholesterolemie","title_en":"","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog","huisarts","internist"],"tags":["biomarkers-cardiovasculair","cardiovasculaire-genetica","diabetes-type-2","familiaire-hypercholesterolemie","familiaire-hypercholesterolemie-screening","gepersonaliseerde-geneeskunde","inflammatie","laminopathie","lipoproteïne-a","menopauze","vrouwen"],"journal":"Atherosclerosis","doi":"10.1016/j.atherosclerosis.2026.120650","source_url":"https://doi.org/10.1016/j.atherosclerosis.2026.120650","authors":["María Elena Mansilla-Rodríguez","José Luis Sánchez-Ramos","Alina Rigabert Sánchez-Junco","Jing Pang","Dick C Chan","Eva Nadiejda Gutiérrez-Cortizo","Pedro Mata","Gerald F Watts","Manuel Jesús Romero-Jiménez"],"significance":6,"published":"2026-05-06","source_date":"2026-04-01","image":"","kennis":["https://hartvaat.nl/kennis/preventie/risicofactoren-cardiovasculair/","https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/"],"congress":"","summary_en":"A systematic review and meta-analysis (21 studies, 23,613 genetically confirmed heterozygous FH patients, 3,489 cardiovascular events) showed independent associations between ASCVD and hypertension (effect size 0.41), male sex (0.33), smoking (0.32), Lp(a) (0.22), age (0.21), BMI (0.11), triglycerides (0.08) and LDL-C (0.02). Beyond intensive LDL lowering, aggressive management of classic risk factors — especially blood pressure and smoking — is essential to limit residual risk in this high-risk group.","created":"2026-07-03T10:32:51Z","updated":"2026-07-03T13:31:47Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Systematische review en meta-analyse (21 studies, 23.613 patiënten met genetisch bevestigde heterozygote FH, 3.489 cardiovasculaire events) liet zien dat hypertensie (effect size 0,41), mannelijk geslacht (0,33), roken (0,32), Lp(a) (0,22), leeftijd (0,21), BMI (0,11), triglyceriden (0,08) en LDL-C (0,02) onafhankelijk geassocieerd zijn met ASCVD. Naast intensieve LDL-verlaging is dus actieve aanpak van klassieke risicofactoren — vooral bloeddruk en roken — essentieel om het cardiovasculaire risico in deze hoogrisicogroep te beperken.","abstract_original":"BACKGROUND AND AIMS: Familial hypercholesterolemia (FH) is a highly prevalent monogenic disorder characterized by elevated low-density lipoprotein-cholesterol (LDL-C) levels and premature atherosclerotic cardiovascular disease (ASCVD). The risk factors associated with cardiovascular events in this population vary considerably among studies. This systematic review aims to identify the key risk factors predicting cardiovascular events in patients with a confirmed genetic diagnosis of heterozygous FH (PROSPERO, CRD42022304273). METHODS AND ANALYSIS: Cochrane Library, Embase, MEDLINE, Scopus, UpToDate and other literature databases were searched from inception to June 2023. Records were eligible if they included studies reporting risk factors for ASCVD endpoints in adult patients with a genetic diagnosis of FH. A meta-analysis was performed using MetaEasy. RESULTS: A total of 21 studies were identified, involving 23,613 individual participants and 3489 prevalent cardiovascular events. The sex distribution was 47.2% male and 52.8% female. Most of the studies were conducted in European populations, representing 90.5% of the total. The meta-analysis found associations between ASCVD and hypertension (effect size 0.414; 95% CI: 0.346-0.482), male sex (0.334; 0.213-0.456), smoking (0.324; 0.203-0.445), lipoprotein(a) (0.219; 0.127-0.312), age (0.212; 0.161-0.264), body mass index (0.108; 0.028-0.188), triglycerides (0.084; 0.057-0.111) and LDL-C (0.015; 0.002-0.028). CONCLUSIONS: This is the first systematic review and meta-analysis demonstrating that hypertension, male sex, smoking, lipoprotein(a), age, body mass index, triglycerides and LDL-C are significantly and independently associated with ASCVD in genetically confirmed patients with heterozygous FH. These data can inform risk stratification models and optimise therapy in such patients."}