Abstract 4113890: Impact of blood pressure management on cardiovascular events among patients with familial hypercholesterolemia

Background: Hypertension status has been associated with worse outcomes among patients with familial hypercholesterolemia (FH). We aimed to determine clinical impact of management of blood pressure in development of major adverse cardiovascular events (MACE). Methods: Patients with clinically diagnosed heterozygous FH (HeFH) (N=1,273, male/female=614/659) with blood pressure data were assessed. We divided the patients into 4 groups (group 1: patients without hypertension from baseline to their follow-up, group 2: patients without hypertension at baseline, but developed hypertension at follow-up, group 3: patients with hypertension at baseline, but well-controlled at follow-up, group 4: patients with hypertension from baseline and uncontrolled at their follow-up). Cox proportional hazards models were used to assess factors associated with MACE, including cardiovascular death and any coronary events. Results: The median follow-up period was 10.9 years. During the follow-up period, 142 MACEs were observed. We found that the management of blood pressure was significantly associated with the occurrence of MACE (hazard ratio (HR): 2.50; 95% confidence interval (CI): 1.30–3.70; p<0.001, HR: 4.18; 95% CI: 2.08–6.28; p<0.001, HR: 10.96; 95% CI: 6.10–17.58; p<0.001, in group 2, group 3, and group 4, respectively when group 1 was considered as reference). Conclusions: Blood pressure management appears to be very important among patients with HeFH.