In Familial Hypercholesterolemia, women treated less aggress
Researchers utilized the FH Canada registry, which is comprised of 19 academic centers, to identify sex differences in the treatment and target lipid achievement among 289 patients with FH at the McGill University Health Centre (127 women). Change in LDL at baseline were compared to levels at most recent visit.

On average, women were a little older (49 vs. 45 years; P = .041); with lower Framingham Risk Score (4.5 vs. 6.7; P = .001); lower BMI (25.6 vs. 28.3 kg/m2; P < .001); and fewer prior CAD events (20.5% vs. 35.8%; P = .016) compared with men. At baseline, among patients already on lipid-lowering therapy, women had greater mean total cholesterol (213.8 vs. 186.8 mg/dL; P = .01), HDL (53.8 vs. 44.5 mg/dL; P < .001) and apolipoprotein B (1.11 vs. 0.97 g/L; P < 007) compared with men.

Among women not on lipid-lowering therapy at baseline, mean total cholesterol and Apo B were comparable with men; however, mean HDL remained higher (56.5 vs. 44.5 mg/dL; P < .001) and triglycerides were lower (101.9 vs. 155 mg/dL; P < 007) compared with men not on lipid-lowering therapy. By the time of their most recent visit, women with FH were less likely to be prescribed a high-intensity statin (35.3% vs. 74.1%; P = .002); were more often treated with a low-intensity statin (41.2% vs. 14.7%; P < .001); and were more likely to report statin intolerance (40% vs. 21.6%; P = .017) compared with men with FH.

Although both men and women with FH experienced LDL reduction at the time of their most recent visit, the change was larger for men compared with women, with an average reduction of 51.6% in women and 62.1%in men (P = .011). The proportion of patients with certain LDL concentrations at follow-up was as follows:
# 2.5 mmol/L at follow-up (32.1% in women vs. 54.6% in men; P = .022);
# 3.0 mmol/L at follow-up (46.9% in women vs. 73.6% in men; P = .021); and
# > 4.0 mmol/L at follow-up (21% in women vs. 7.3% in men; P = .01)

Source: https://www.healio.com/news/cardiology/20220604/in-fh-women-treated-less-aggressively-than-men
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