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February 6, 2026European Heart Journal0 citations

Ischemic stroke in patients with familial hypercholesterolemia: insights from a cross-sectional analysis of the HELLAS-FH registry

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MFMatilda FlorentinCMC MilionisCRC V Rizos

Key Result

Familial hypercholesterolemia patients with a history of ischemic stroke (2.7%) were older and had a higher prevalence of hypertension (54.3% vs 25.1%) and diabetes (25.9% vs 7.7%).

Key Points

  • The study aims to characterize and compare cardiovascular risk factors in familial hypercholesterolemia patients with and without ischemic stroke history.
  • Conducted a cross-sectional analysis using data from the HELLAS-FH registry.
  • Compared baseline characteristics of FH patients with prior ischemic stroke to those without.
  • Evaluated cardiovascular risk factors and therapeutic regimens.
  • Out of 3,032 participants, 82 (2.7%) had a history of ischemic stroke.
  • Stroke patients were older, with a mean age of 58.4 years compared to 49.4 years in non-stroke patients.
  • Higher prevalence of hypertension (54.3% in stroke patients vs. 25.1% in non-stroke) and diabetes (25.9% vs. 7.7%).
  • No significant differences in baseline lipid profiles between the two groups.

Study Design

Type

Cross-Sectional (n=3,032)

Structured PICO

P
Population
3,032 patients with familial hypercholesterolemia (FH) from the HELLAS-FH registry
O
Outcome
Differences in baseline characteristics, cardiovascular risk factors, and therapeutic approaches between FH patients with and without a history of ischemic stroke

In patients with familial hypercholesterolemia, a history of ischemic stroke is strongly associated with traditional cardiovascular risk factors like hypertension and diabetes, emphasizing the need for comprehensive risk factor management beyond just lipid-lowering therapy.

Main Result

Absolute Event Rate: 54.3% vs 25.1%

p-value: p=<0.05

Abstract

Abstract Background and Aims Familial hypercholesterolemia (FH) is a genetic disorder linked to a significantly increased risk of atherosclerotic cardiovascular disease (ASCVD), primarily presenting as premature coronary artery disease (CAD). Purpose The clinical and risk factor profiles of FH patients with a history of ischemic stroke remain poorly characterized. With the present study we aimed to assess differences in baseline characteristics, cardiovascular risk factors and therapeutic approaches between FH patients with and without a history of ischemic stroke. Methods This cross-sectional analysis exploited data from the HELLAS-FH registry. Baseline characteristics, including anthropometric parameters, lipid profiles, history of ASCVD and therapeutic regimens, were compared between FH patients with and without prior ischemic stroke. Results Of 3,032 participants, 82 (2.7%) had a history of ischemic stroke. Patients with prior stroke were older (58.4 ± 13.9 vs. 49.4 ± 14.4 years), had higher systolic (134.7 ± 16.7 vs. 126.4 ± 14.5 mmHg) and diastolic (80.6 ± 10.1 vs. 77.0 ± 9.7 mmHg) blood pressure, as well as a higher prevalence of hypertension (54.3% vs. 25.1%) and diabetes mellitus (25.9% vs. 7.7%) compared with those without such a history (p 0.05 for all comparisons). Baseline lipid profiles did not differ between the two groups. However, patients with prior stroke had higher prevalence of CAD and peripheral artery disease, both overall and premature (p 0.05 for all comparisons). Conclusions FH patients with a history of ischemic stroke are older and have higher prevalence of hypertension and diabetes, underscoring the need for more aggressive management of these risk factors beyond lipid-lowering strategies.

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Cite This Study

Florentin et al. (2025) conducted a cross-sectional in Familial hypercholesterolemia (n=3,032). History of ischemic stroke vs. No history of ischemic stroke was evaluated on Prevalence of hypertension (p=<0.05). Familial hypercholesterolemia patients with a history of ischemic stroke (2.7%) were older and had a higher prevalence of hypertension (54.3% vs 25.1%) and diabetes (25.9% vs 7.7%).

synapsesocial.com/papers/698585db8f7c464f230099d4https://doi.org/10.1093/eurheartj/ehaf784.3046
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