Long-term LDL-c lowering in heterozygous familial hypercholesterolemia normalizes carotid intima-media thickness

Objective: We investigated the effectiveness of statins in daily practice in reducing the arterial wall thicknesses by comparing the carotid intima-media thickness (cIMT) between statin-treated familial hypercholesterolemia (FH) patients and their unaffected spouses. Methods: FH subjects treated with LDL-c lowering medication for at least 5 years and their unaffected spouses were included in this observational study. Clinical data and carotid intima-media thickness (cIMT) as surrogate marker for atherosclerosis were acquired. Results: In total 40 FH patients, age 48.4 +/- 4.2 years, and their 40 unaffected spouses, age 47.4 +/- 3.9 years, were included. Pre-treatment total cholesterol levels of FH patients were on average 9.3 +/- 2.0 mmol/L. Treated FH patients and unaffected spouses exhibited similar LDL-c (3.8 +/- 1.5 vs. 3.5 +/- 1.1 mmol/L; p = 0.25) and total cholesterol levels (5.8 +/- 1.6 vs. 5.6 +/- 1.1 mmol/L; p = 0.56). Also, in a multivariate model cIMT adjusted for age and sex did not differ between affecteds and spouses (95% CI: -0.032 to 0.092mm; p = 0.34). Conclusion: Long-term statin treatment normalizes cIMT in severe FH patients and therefore it is likely that the extreme risk of cardiovascular disease in FH patients is significantly reduced by this therapy. (C) 2010 Elsevier Ireland Ltd. All rights reserved