title: Medication adherence, cascade screening, and lifestyle patterns among women with hypercholesterolemia: Results from the WomenHeart survey.
abstract: Hypercholesterolemia is a major risk factor for cardiovascular disease. Women with hypercholesterolemia and familial hypercholesterolemia (FH) are a high-risk group often underdiagnosed, undertreated, and unaware of the need for cascade screening.
  
  
  
  The objectives were to identify the prevalence of hypercholesterolemia and FH in 2 national databases, explore lifestyle/medication adherence, and examine rates of cascade screening (lipid testing in all first-degree relatives) among those with FH.
  
  
  
  This was a cross-sectional study of women who completed an online survey in 2014. Outcomes were examined for 3 groups: diagnosed, probable, and no FH. For FH, multivariable logistic regression was used to examine the association between family member screening for FH and sociodemographic and/or clinical characteristics.
  
  
  
  There were 761 respondents with a mean (±standard deviation) age of 59 ± 10.1 years; 26% reported FH, 22% probable FH, and 51% no FH. Eighty-three percent of the total sample and 95% with FH take a statin. In those with hypercholesterolemia and FH, 65% and 58% reported high medication adherence, respectively. Women with probable FH consumed significantly fewer fruits/vegetables and were less active. FH cascade screening was: siblings 54%, parents 37%, and children 34%. Marital status, annual household income, and diabetes were significantly associated with cascade screening.
  
  
  
  In a survey of informed women with hypercholesterolemia and FH, cascade screening is underused. Our findings warrant increased efforts to identify cascade screening barriers. Early detection and treatment of hypercholesterolemia/FH is a priority for women, and their first-degree relatives, as this may dramatically reduce cardiovascular disease impact.
authors: Population Health, Minneapolis Heart Institute Foundation, Minneapolis, MN, USA. Electronic address: gbenson@mhif.org.
authors: Gretchen
authors: G
authors: Benson
authors: Population Health, Minneapolis Heart Institute Foundation, Minneapolis, MN, USA.
authors: Dawn R
authors: DR
authors: Witt
authors: Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Foundation, Marshfield, WI, USA.
authors: Jeffrey J
authors: JJ
authors: VanWormer
authors: WomenHeart, Washington, DC, USA.
authors: Susan M
authors: SM
authors: Campbell
authors: Division of Applied Research, Allina Health, Minneapolis, MN, USA.
authors: Arthur
authors: A
authors: Sillah
authors: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
authors: Sharonne N
authors: SN
authors: Hayes
authors: Population Health, Minneapolis Heart Institute Foundation, Minneapolis, MN, USA.
authors: Matt
authors: M
authors: Lui
authors: Division of Cardiology, University of Arizona, Phoenix, AZ, USA.
authors: Martha
authors: M
authors: Gulati
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy* / Q000453:epidemiology*; D008019:Life Style; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D016903:Drug Monitoring
keywords: Cascade screening; Familial hypercholesterolemia; Hypercholesterolemia; Lifestyle; Medication adherence; Nutrition; Prevention; Women