Familial hypercholesterolemia prevalence in an admixed racial society: Sex and race matter. The ELSA-Brasil

Atherosclerosis. 2018 Oct:277:273-277. doi: 10.1016/j.atherosclerosis.2018.08.021.

Abstract

Background and aims: Familial hypercholesterolemia (FH) is a genetic disorder associated with high cardiovascular burden of disease. FH prevalence may vary widely across populations and data in race/ethnically diverse and admixed populations is scarce. ELSA-Brasil epidemiology may be widely generalizable in this regard, and we calculated the ELSA-Brasil FH prevalence and its variation according to age, sex and race/ethnicity.

Methods: In 14,460 individuals aged from 35 to 75 years from the ELSA-Brasil cohort baseline, we classified FH according to the Dutch Lipid Clinic Network criteria score ≥6 (probable and definite FH). LDL-C levels were adjusted for statin use. We calculated the overall ELSA-Brasil FH prevalence and the weighted prevalence for age, sex and race/ethnic categories. We extrapolated those frequencies to the Brazilian population weighting for age-sex-race/ethnicity according to the 2015 Statistics and Geography Brazilian Institute survey.

Results: The overall FH prevalence per 1000 individuals in ELSA-Brasil was 3.8 (2.9, 4.9) or 1 in 263. The age/sex/race-ethnicity-weighted FH prevalences were: male, 3.0 (1.7, 4.4) or 1 in 333; female, 4.1 (3.0, 5.2) or 1 in 244 (p<0.001). White race prevalence was 2.4 (1.9, 3.0) or 1 in 417; Brown, 4.9 (4.0, 5.9) or 1 in 204; and Black 6.4 (41.1, 8.7) or 1 in 156 (p<0.001). The weighted extrapolation for the Brazilian population derived similar magnitude frequencies.

Conclusions: FH affects 1 in 263 in ELSA-Brasil and affects disproportionally more Brown (1 in 204), and Black (1 in 156), than White (1 in 417). Weighted extrapolation for the Brazilian population derived similar magnitude frequencies.

Keywords: Epidemiology; Ethnicity; Familial hypercholesterolemia; Prevalence; Race; Sex.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Biomarkers / blood
  • Black People* / genetics
  • Brazil / epidemiology
  • Cholesterol, LDL / blood
  • Cross-Sectional Studies
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Hyperlipoproteinemia Type II / blood
  • Hyperlipoproteinemia Type II / diagnosis
  • Hyperlipoproteinemia Type II / ethnology*
  • Hyperlipoproteinemia Type II / genetics
  • Male
  • Middle Aged
  • Phenotype
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • White People* / genetics

Substances

  • Biomarkers
  • Cholesterol, LDL