ArticleEuropean heart journal2025
Overweight, obesity, and cardiovascular disease in heterozygous familial hypercholesterolaemia: the EAS FH Studies Collaboration registry.
Abstract readMulticenter Study
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Article in European heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14citing papers in PubMed
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Who cites it
14 citing papers in PubMed.
- Swimming exercise counteracts metabolic and skeletal dysfunction in LDL receptor-deficient mice exposed to a high-fat diet.European journal of applied physiology · 2026Article
- Decoding Primary Hyperlipoproteinemias: A Focus on the Pathogenesis and Diagnosis of Familial Hypercholesterolemia and Familial Combined Hyperlipidemia.Diagnostics (Basel, Switzerland) · 2026Review
- Familial Hypercholesterolemia in Women: Diagnosis, Treatment, and Cardiovascular Outcomes Across the Lifespan.Current atherosclerosis reports · 2026Review
- Article
- Effect of rosuvastatin and ezetimibe therapy on LDL-cholesterol reduction and non-invasive arterial injury markers in children with heterozygous familial hypercholesterolemia: a prospective, open-label, randomized study.Frontiers in cardiovascular medicine · 2026Article
- Article
- Mediterranean diet, eating behaviours, and nutritional intervention in childhood obesity: what works, where, and for whom-a narrative review.Frontiers in nutrition · 2026Review
- Familial Hypercholesterolemia.Methodist DeBakey cardiovascular journal · 2026Review
- Prevalence of Carotid Atherosclerotic Plaques and Stenosis in Adults with Familial Hypercholesterolemia Needs Reappraisal: Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Diagnostic and Therapeutic Challenges of Homozygous and Severe Heterozygous Familial Hypercholesterolemia from Clinical Aspect-A Single-Center Study.Journal of clinical medicine · 2025Article
- Proposed lipidology and preventive cardiology research priorities in Africa; Results of a Delphi survey.Atherosclerosis plus · 2025Article
- Beyond lipid levels: unraveling the hypertensive factor in familial hypercholesterolemia. The HELLAS-FH registry.Journal of human hypertension · 2025Article
- Obesity in familial hypercholesterolaemia: when precision medicine should meet precision population health.European heart journal · 2025Article
- Association between estimated glucose disposal rate and the risk of atherosclerotic cardiovascular disease: insight from cross-sectional and retrospective cohort studies.Frontiers in nutrition · 2025Article
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Authors and funding
83 authors.
Amany ElshorbagyDepartment of Primary Care and Public Health, Imperial Centre for Cardiovascular Disease Prevention, School of Public Health, Imperial College London, White City Campus, 90 Wood Lane, London W12 0BZ, UK.
Antonio J Vallejo-VazDepartment of Primary Care and Public Health, Imperial Centre for Cardiovascular Disease Prevention, School of Public Health, Imperial College London, White City Campus, 90 Wood Lane, London W12 0BZ, UK.
Fotios BarkasDepartment of Primary Care and Public Health, Imperial Centre for Cardiovascular Disease Prevention, School of Public Health, Imperial College London, White City Campus, 90 Wood Lane, London W12 0BZ, UK.
Alexander R M LyonsDepartment of Primary Care and Public Health, Imperial Centre for Cardiovascular Disease Prevention, School of Public Health, Imperial College London, White City Campus, 90 Wood Lane, London W12 0BZ, UK.
Christophe A T StevensDepartment of Primary Care and Public Health, Imperial Centre for Cardiovascular Disease Prevention, School of Public Health, Imperial College London, White City Campus, 90 Wood Lane, London W12 0BZ, UK.
Kanika I DharmayatDepartment of Primary Care and Public Health, Imperial Centre for Cardiovascular Disease Prevention, School of Public Health, Imperial College London, White City Campus, 90 Wood Lane, London W12 0BZ, UK.
Alberico L CatapanoDepartment of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy.
Tomas FreibergerCentre for Cardiovascular Surgery and Transplantation, and Medical Faculty, Masaryk University, Brno, Czech Republic.
G Kees HovinghDepartment of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Pedro MataFundación Hipercolesterolemia Familiar, Madrid, Spain.
Frederick J RaalCarbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Raul D SantosHeart Institute (InCor), University of São Paulo and Hospital Israelita Albert Einstein, São Paulo, Brazil.
Handrean SoranManchester University NHS Foundation Trust, Manchester, UK.
Gerald F WattsFaculty of Health and Medical Sciences, School of Medicine, University of Western Australia, Perth, WA, Australia.
Marianne AbifadelFaculty of Pharmacy, Laboratory of Biochemistry and Molecular Therapeutics, Saint Joseph University, Beirut, Lebanon.
Carlos A Aguilar-SalinasUnidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México.
Khalid F AlhabibDepartment of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Mutaz AlkhnifsawiCollege of Pharmacy, University of Al Qadisiyah, Al Diwaniyah, Iraq.
Wael AlmahmeedCleveland Clinic Abu Dhabi, Heart and Vascular Institute, Abu Dhabi, United Arab Emirates.
Fahad AlnouriCardiovascular Prevention Unit, Adult Cardiology Department, Prince Sultan Cardiac Centre, Riyadh, Saudi Arabia.
Rodrigo AlonsoCentre for Advanced Metabolic Medicine and Nutrition, Santiago, Chile.
Khalid Al-RasadiDepartment of Biochemistry, College of Medicine and Health Science and Medical Research Centre, Sultan Qaboos University, Muscat, Oman.
Ahmad Al-SarrafSabah Al Ahmad Cardiac Centre, Kuwait City, Kuwait.
Marcello ArcaDepartment of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Tester F AshavaidDepartment of Laboratory Medicine, PD Hinduja Hospital and Medical Research Centre Mahim, Mumbai, India.
Maurizio AvernaDepartment of Health Promotion Sciences, Maternal and Infantile Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
Maciej BanachDepartment of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Lodz, Poland.
Marianne BeckerDepartment of Pediatric Endocrinology and Diabetology, Centre hospitalier de Luxembourg, Luxembourg City, Luxembourg.
Christoph J BinderDepartment of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
Mafalda BourbonUnidade de Investigação e Desenvolvimento, Grupo de Investigação Cardiovascular, Departamento de Promoção da Saúde e Prevenção de Doenças Não Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal.
Liam R BrunhamDepartments of Medicine and Medical Genetics, Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, Canada.
Krzysztof Chlebus1st Department of Cardiology Medical University of Gdańsk, National Centre of Familial Hypercholesterolaemia in Gdańsk, Gdańsk, Poland.
Pablo CorralPharmacology Department, FASTA University, School of Medicine, Mar del Plata, Argentina.
Diogo CruzPortuguese Atherosclerosis Society, Lisbon, Portugal.
Kairat DavletovResearch Health Institute, Al Farabi Kazakh National University, Almaty, Kazakhstan.
Olivier S DescampsCentres Hospitaliers Universitaires HELORA at La Louvière and University of Mons, Mons, Belgium.
Bambang DwiputraFaculty of Medicine, Department of Cardiology and Vascular Medicine, Universitas Indonesia-Harapan Kita National Cardiovascular Center, Jakarta, Indonesia.
Marat EzhovNational Medical Research Centre of Cardiology of Ministry of Health of the Russian Federation, Moscow, Russia.
Urh GroseljDepartment of Paediatric Endocrinology, Diabetes and Metabolism, University Medical Centre, University Children's Hospital Ljubljana, Ljubljana, Slovenia.
Mariko Harada-ShibaOsaka Medical and Pharmaceutical University, Takatsuki, Japan.
Kirsten B HolvenNational Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Oslo, Norway.
Steve E HumphriesCentre for Cardiovascular Genetics, Institute for Cardiovascular Science, University College London, London, UK.
Meral KayikciogluDepartment of Cardiology, Ege University Medical School, İzmir, Turkey.
Weerapan KhovidhunkitFaculty of Medicine, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Katarina LalicFaculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University of Belgrade, Belgrade, Serbia.
Gustavs LatkovskisFaculty of Medicine, Research Institute of Cardiology and Regenerative Medicine, University of Latvia, Pauls Stradins Clinical University Hospital, Riga, Latvia.
Ulrich LaufsKlinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, Germany.
Evangelos LiberopoulosFirst Department of Propaedeutic and Internal Medicine, School of Medicine, National and Kapodistian University of Athens, Athens, Greece.
Marcos M Lima-MartinezUniversidad de Oriente, Núcleo Bolívar, Ciudad Bolívar, Venezuela.
Vincent MaherAdvanced Lipid Management and Research Centre (ALMAR), Tallaght University Hospital, Dublin, Ireland.
A David MaraisChemical Pathology, University of Cape Town Health Science Faculty, Cape Town, South Africa.
Winfried MärzDACH Society for the Prevention of Heart and Circulatory Diseases, Hamburg, Germany.
Erkin MirrakhimovKyrgyz State Medical Academy, Bishkek, Kyrgyzstan.
André R MiserezDiagene Research Institute and Swiss Society for Familial Forms of Hypercholesterolemia (SSFH), Reinach, Switzerland.
Olena MitchenkoDepartment of Dyslipidaemia, Institute of Cardiology, National Academy of Medical Sciences, Kiev, Ukraine.
Hapizah NawawiInstitute of Pathology, Laboratory and Forensic Medicine (I-PPerForM) and Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia.
Børge G NordestgaardHerlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark.
Andrie G PanayiotouDepartment of Rehabilitation Sciences, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
György ParaghFaculty of Medicine, Division of Metabolic Diseases, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary.
Zaneta PetrulionieneVilnius University Faculty of Medicine and Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.
Belma PojskicFaculty of Medicine, Cantonal Hospital Zenica, University of Zenica, Zenica, Bosnia and Herzegovina.
Arman PostadzhiyanMedical University of Sofia, Sofia, Bulgaria.
Ashraf RedaFaculty of Medicine, Department of Cardiology, Menoufia University, Al Minufiyah, Egypt.
Željko ReinerDepartment of Internal Medicine, University Hospital Centre Zagreb, and School of Medicine, University of Zagreb, Zagreb, Croatia.
Ximena ReyesGENYCO Program, Comisión Honoraria para la Salud Cardiovascular, Montevideo, Uruguay.
Fouzia SadiqDirectorate of Research, Shifa Tameer-e-Millat University, Islamabad, Pakistan.
Wilson Ehidiamen SadohDepartment of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria.
Heribert SchunkertClinic for Heart and Circulatory Diseases, German Heart Centre Munich, Technical University Munich, Munich, Germany.
Aleksandr B ShekDepartment of Coronary Heart Disease and Atherosclerosis, Republican Specialized Centre of Cardiology, Ministry of Health of Republic Uzbekistan, Tashkent, Uzbekistan.
Erik StroesDepartment of Vascular Medicine, D3.330, AMC, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands.
Ta-Chen SuDepartments of Environmental and Occupational Medicine, and Internal Medicine (Cardiology Division), National Taiwan University Hospital, Taipei, Taiwan.
Tavintharan SubramaniamAdmiralty Medical Centre and Khoo Teck Puat Hospital, Yishun Health, Singapore.
Andrey V SusekovFederal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Healthcare of the Russian Federation, Moscow, Russia.
Myra TilneyLipid Clinic, Mater Dei Hospital, Msida, Malta.
Brian TomlinsonFaculty of Medicine, Macau University of Science and Technology, Macau, China.
Thanh Huong TruongFaculty of Medicine, Phenikaa University, Vietnam Atherosclerosis Society, Hanoi, Vietnam.
Alexandros D TselepisAtherothrombosis Research Centre, University of Ioannina, Ioannina, Greece.
Anne Tybjærg-HansenRigshospitalet, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark.
Alejandra Vázquez-CárdenasDepartamento Académico Ciclo de Vida, Universidad Autónoma de Guadalajara, Av. Patria 1201, Zapopan 45129, México.
Margus ViigimaaNorth Estonia Medical Centre, Tallinn University of Technology, Tallinn, Estonia.
Branislav VohnoutDepartment of Diabetology, LF SZU, Institute of Nutrition, FOaZOS, Coordination Centre for Familial Hyperlipidemias, Slovak Medical University in Bratislava, Bratislava, Slovakia.
Shizuya YamashitaRinku General Medical Centre, Osaka, Japan.
Kausik K RayDepartment of Primary Care and Public Health, Imperial Centre for Cardiovascular Disease Prevention, School of Public Health, Imperial College London, White City Campus, 90 Wood Lane, London W12 0BZ, UK.
Funding
Beatriz GalindoImperial NIHR Biomedical Research CentreMinistry of Higher EducationMinistry of UniversitiesMOHEMPNNational Institute for Health and Care ResearchNational Professorial CouncilNIHR Applied Research Collaboration Northwest LondonUiTMUniversiti Teknologi MARAUniversity of Seville
Abstract
BACKGROUND AND
aimsOverweight and obesity are modifiable risk factors for atherosclerotic cardiovascular disease (ASCVD) in the general population, but their prevalence in individuals with heterozygous familial hypercholesterolaemia (HeFH) and whether they confer additional risk of ASCVD independent of LDL cholesterol (LDL-C) remains unclear.
methodsCross-sectional analysis was conducted in 35 540 patients with HeFH across 50 countries, in the EAS FH Studies Collaboration registry. Prevalence of World Health Organization-defined body mass index categories was investigated in adults (n = 29 265) and children/adolescents (n = 6275); and their association with prevalent ASCVD.
resultsGlobally, 52% of adults and 27% of children with HeFH were overweight or obese, with the highest prevalence noted in Northern Africa/Western Asia. A higher overweight/obesity prevalence was found in non-high-income vs. high-income countries. Median age at familial hypercholesterolaemia diagnosis in adults with obesity was 9 years older than in normal weight adults. Obesity was associated with a more atherogenic lipid profile independent of lipid-lowering medication. Prevalence of coronary artery disease increased progressively across body mass index categories in both children and adults. Compared with normal weight, obesity was associated with higher odds of coronary artery disease in children (odds ratio 9.28, 95% confidence interval 1.77-48.77, adjusted for age, sex, lipids, and lipid-lowering medication) and coronary artery disease and stroke in adults (odds ratio 2.35, 95% confidence interval 2.10-2.63 and odds ratio 1.65, 95% confidence interval 1.27-2.14, respectively), but less consistently with peripheral artery disease. Adjusting for diabetes, hypertension and smoking modestly attenuated the associations.
conclusionsOverweight and obesity are common in patients with HeFH and contribute to ASCVD risk from childhood, independent of LDL-C and lipid-lowering medication. Sustained body weight management is needed to reduce the risk of ASCVD in HeFH.
Indexed as
Cardiovascular DiseasesHyperlipoproteinemia Type IIObesityOverweightAdolescentAdultAgedBody Mass IndexChildCholesterol, LDLCross-Sectional StudiesFemaleHeterozygoteHumansMaleMiddle AgedCholesterol, LDLAdiposityAtherosclerosisDyslipidaemiaInsulin resistance
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