title: Treatment Gaps in Adults With Heterozygous Familial Hypercholesterolemia in the United States: Data From the CASCADE-FH Registry.
abstract: BACKGROUND
  Cardiovascular disease burden and treatment patterns among patients with familial hypercholesterolemia (FH) in the United States remain poorly described. In 2013, the FH Foundation launched the Cascade Screening for Awareness and Detection (CASCADE) of FH Registry to address this knowledge gap.
  
  
  RESULTS
  We conducted a cross-sectional analysis of 1295 adults with heterozygous FH enrolled in the CASCADE-FH Registry from 11 US lipid clinics. Median age at initiation of lipid-lowering therapy was 39 years, and median age at FH diagnosis was 47 years. Prevalent coronary heart disease was reported in 36% of patients, and 61% exhibited 1 or more modifiable risk factors. Median untreated low-density lipoprotein cholesterol (LDL-C) was 239 mg/dL. At enrollment, median LDL-C was 141 mg/dL; 42% of patients were taking high-intensity statin therapy and 45% received >1 LDL-lowering medication. Among FH patients receiving LDL-lowering medication(s), 25% achieved an LDL-C <100 mg/dL and 41% achieved a ≥50% LDL-C reduction. Factors associated with prevalent coronary heart disease included diabetes mellitus (adjusted odds ratio 1.74; 95% confidence interval 1.08-2.82) and hypertension (2.48; 1.92-3.21). Factors associated with a ≥50% LDL-C reduction from untreated levels included high-intensity statin use (7.33; 1.86-28.86) and use of >1 LDL-lowering medication (1.80; 1.34-2.41).
  
  
  CONCLUSIONS
  FH patients in the CASCADE-FH Registry are diagnosed late in life and often do not achieve adequate LDL-C lowering, despite a high prevalence of coronary heart disease and risk factors. These findings highlight the need for earlier diagnosis of FH and initiation of lipid-lowering therapy, more consistent use of guideline-recommended LDL-lowering therapy, and comprehensive management of traditional coronary heart disease risk factors.
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Emil M
authors.initials: EM
authors.lastname: deGoma
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Zahid S
authors.initials: ZS
authors.lastname: Ahmad
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Emily C
authors.initials: EC
authors.lastname: O'Brien
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Iris
authors.initials: I
authors.lastname: Kindt
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Peter
authors.initials: P
authors.lastname: Shrader
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Connie B
authors.initials: CB
authors.lastname: Newman
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Yashashwi
authors.initials: Y
authors.lastname: Pokharel
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Seth J
authors.initials: SJ
authors.lastname: Baum
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Linda C
authors.initials: LC
authors.lastname: Hemphill
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Hudgins
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Catherine D
authors.initials: CD
authors.lastname: Ahmed
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Gidding
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Danielle
authors.initials: D
authors.lastname: Duffy
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: William
authors.initials: W
authors.lastname: Neal
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Katherine
authors.initials: K
authors.lastname: Wilemon
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Roe
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Rader
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: MacRae F
authors.initials: MF
authors.lastname: Linton
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: P Barton
authors.initials: PB
authors.lastname: Duell
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Michael D
authors.initials: MD
authors.lastname: Shapiro
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.).
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Moriarty
authors.affiliation: From the University of Pennsylvania, Philadelphia (E.M.d., D.J.R.); University of Texas Southwestern, Dallas (Z.S.A.); Duke Clinical Research Institute, Durham, NC (E.C.O., P.S., M.T.R.); The FH Foundation, South Pasadena, CA (I.K., C.D.A., K.W.); New York University School of Medicine (C.B.N.); Mid America Heart Institute, Kansas City, MO (Y.P.); Preventive Cardiology Inc, Boca Raton, FL (S.J.B.); Massachusetts General Hospital, Boston (L.C. Hemphill); The Rogosin Institute, New York, NY (L.C. Hudgins); Nemours Cardiac Center, Wilmington, DE (S.S.G.); Thomas Jefferson University Hospital, Philadelphia, PA (D.D.); West Virginia University, Morgantown (W.N.); Baylor College of Medicine, Houston, TX (C.M.B.); Vanderbilt University School of Medicine, Nashville, TN (M.F.L.); Oregon Health and Science University, Portland, OR (P.B.D., M.D.S.); University of Kansas Medical Center (P.M.M.); and Stanford University, CA (J.W.K.). knowlej@stanford.edu.
authors.forename: Joshua W
authors.initials: JW
authors.lastname: Knowles
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D008078:Cholesterol, LDL / Q000097:blood; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology / Q000235:genetics / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D015536:Down-Regulation; D042241:Early Diagnosis; D005260:Female; D020022:Genetic Predisposition to Disease; D019983:Guideline Adherence; D006579:Heterozygote; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010641:Phenotype; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011237:Predictive Value of Tests; D015995:Prevalence; D000071836:Professional Practice Gaps / Q000592:standards; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: coronary artery disease; familial hypercholesterolemia; genetic heart disease; low-density lipoprotein cholesterol; statin therapy