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Health disparities among adult patients with a phenotypic diagnosis of familial hypercholesterolemia in the CASCADE-FH™ patient registry.

Publication ,  Journal Article
Amrock, SM; Duell, PB; Knickelbine, T; Martin, SS; O'Brien, EC; Watson, KE; Mitri, J; Kindt, I; Shrader, P; Baum, SJ; Hemphill, LC; Ahmed, CD ...
Published in: Atherosclerosis
December 2017

BACKGROUND AND AIMS: Most familial hypercholesterolemia (FH) patients remain undertreated, and it is unclear what role health disparities may play for FH patients in the US. We sought to describe sex and racial/ethnic disparities in a national registry of US FH patients. METHODS: We analyzed data from 3167 adults enrolled in the CAscade SCreening for Awareness and DEtection of Familial Hypercholesterolemia (CASCADE-FH) registry. Logistic regression was used to evaluate for disparities in LDL-C goals and statin use, with adjustments for covariates including age, cardiovascular risk factors, and statin intolerance. RESULTS: In adjusted analyses, women were less likely than men to achieve treated LDL-C of <100 mg/dL (OR 0.68, 95% CI, 0.57-0.82) or ≥50% reduction from pretreatment LDL-C (OR 0.79, 95% CI, 0.65-0.96). Women were less likely than men to receive statin therapy (OR, 0.60, 95% CI, 0.50-0.73) and less likely to receive a high-intensity statin (OR, 0.60, 95% CI, 0.49-0.72). LDL-C goal achievement also varied by race/ethnicity: compared with whites, Asians and blacks were less likely to achieve LDL-C levels <100 mg/dL (Asians, OR, 0.47, 95% CI, 0.24-0.94; blacks, OR, 0.49, 95% CI, 0.32-0.74) or ≥50% reduction from pretreatment LDL-C (Asians, OR 0.56, 95% CI, 0.32-0.98; blacks, OR 0.62, 95% CI, 0.43-0.90). CONCLUSIONS: In a contemporary US population of FH patients, we identified differences in LDL-C goal attainment and statin usage after stratifying the population by either sex or race/ethnicity. Our findings suggest that health disparities contribute to the undertreatment of US FH patients. Increased efforts are warranted to raise awareness of these disparities.

Duke Scholars

Published In

Atherosclerosis

DOI

EISSN

1879-1484

Publication Date

December 2017

Volume

267

Start / End Page

19 / 26

Location

Ireland

Related Subject Headings

  • Sex Factors
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Prospective Studies
  • Phenotype
  • Odds Ratio
  • Multicenter Studies as Topic
  • Middle Aged
  • Male
 

Citation

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Amrock, S. M., Duell, P. B., Knickelbine, T., Martin, S. S., O’Brien, E. C., Watson, K. E., … Ahmad, Z. S. (2017). Health disparities among adult patients with a phenotypic diagnosis of familial hypercholesterolemia in the CASCADE-FH™ patient registry. Atherosclerosis, 267, 19–26. https://doi.org/10.1016/j.atherosclerosis.2017.10.006
Journal cover image

Published In

Atherosclerosis

DOI

EISSN

1879-1484

Publication Date

December 2017

Volume

267

Start / End Page

19 / 26

Location

Ireland

Related Subject Headings

  • Sex Factors
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Prospective Studies
  • Phenotype
  • Odds Ratio
  • Multicenter Studies as Topic
  • Middle Aged
  • Male