Vascular stiffness in familial hypercholesterolaemia is associated with C-reactive protein and cholesterol burden.
BACKGROUND
Familial hypercholesterolaemia (FH) is characterized by very high serum cholesterol and premature coronary atherosclerosis. Arterial stiffness and atherosclerosis are two major underlying pathophysiologies of arterial disease that are predictive of future cardiovascular events. The aims of this study were to quantify atherosclerosis and arterial stiffness and to evaluate their relationship with high sensitive C-reactive protein (hs-CRP) and the level of exposure to high serum cholesterol in FH patients.


METHODS
We measured traditional risk factors, hs-CRP, intima-media thickness (IMT) of carotid artery, and brachial-ankle pulse wave velocity (baPWV) in 35 heterozygous FH subjects and 17 healthy control subjects. Cholesterol-year score (CYS) was calculated to estimate the lifetime cholesterol burden in FH subjects.


RESULTS
FH subjects had significantly elevated total cholesterol, low-density lipoprotein cholesterol, and carotid IMT compared with those without mutations. Among FH patients, the baPWV and carotid IMT were higher in cases with high cholesterol burden than those without. Similarly, the baPWV and carotid IMT were also higher in cases with elevated hs-CRP (> 1 mg L(-1)) than those without. Multiple linear regression analysis demonstrated CYS and hs-CRP were significant independent predictors of baPWV and IMT in FH patients.


CONCLUSIONS
Both high cholesterol burden and vascular inflammation are not only associated with atherosclerosis, but also contribute to the development of arterial stiffness in FH patients. Early detection of hypercholesterolaemia in FH patients is warranted to prevent the untoward pathophysiologies.
Cheng
H M
HM
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Ye
Z X
ZX
Chiou
K R
KR
Lin
S J
SJ
Charng
M J
MJ
D000328:Adult; D050197:Atherosclerosis / Q000235:genetics* / Q000503:physiopathology; D002097:C-Reactive Protein / Q000502:physiology*; D016022:Case-Control Studies; D004548:Elasticity; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000235:genetics* / Q000503:physiopathology; D008297:Male; D010375:Pedigree; D012307:Risk Factors; D017539:Tunica Intima / Q000503:physiopathology; D014655:Vascular Resistance / Q000502:physiology
D002097:C-Reactive Protein