Familial hypercholesterolaemia in the Malaysian community: Prevalence, under-detection and under-treatment

• Main Authors: Chua, Y.-A (Author), Mohd Kasim, N.A (Author), Nawawi, H. (Author), Ramli, A.S (Author), Razman, A.Z (Author)
• Format: Article
• Language: English
• Published: Japan Atherosclerosis Society 2021
• Series: Journal of Atherosclerosis and Thrombosis
• Subjects: adult; age; anthropometry; antilipemic agent; Article; blood pressure; blood sampling; cholesterol; comorbidity; coronary artery bypass graft; coronary artery disease; cross-sectional study; demography; diabetes mellitus; diastolic blood pressure; drug therapy; Dutch Lipid Clinic Network criteria; early diagnosis; ethnicity; Familial hypercholesterolaemia; familial hypercholesterolemia; family history; female; gender; glucose blood level; heart infarction; high density lipoprotein; human; hydroxymethylglutaryl coenzyme A reductase inhibitor; hypertension; lipid fingerprinting; low density lipoprotein cholesterol; major clinical study; Malaysia; male; medical history; middle aged; people by smoking status; percutaneous coronary intervention; physical examination; prevalence; Prevalence; questionnaire; scoring system; senile arch; systolic blood pressure; triacylglycerol; Under-detected; Under-treated; waist circumference; xanthoma
• Online Access: View Fulltext in Publisher; View in Scopus

 Aim: Familial hypercholesterolaemia (FH) is the most common autosomal dominant lipid disorder, leading to severe hypercholesterolaemia. Early detection and treatment with lipid-lowering medications may reduce the risk of premature coronary artery disease in FH patients. However, there is scarcity of data on FH prevalence, detection rate, treatment and control with lipid-lowering therapy in the Malaysian community. Methods: Community participants (n=5130) were recruited from all states in Malaysia. Blood samples were collected for lipid profiles and glucose analyses. Personal and family medical histories were collected by means of assisted questionnaire. Physical examination for tendon xanthomata and premature corneal arcus were conducted on-site. FH were clinically screened using Dutch Lipid Clinic Network Criteria. Results: Out of 5130 recruited community participants, 55 patients were clinically categorised as potential (Definite and Probable) FH, making the prevalence FH among the community as 1:100. Based on current total population of Malaysia (32 million), the estimated number of FH patients in Malaysia is 320,000, while the detection rates are estimated as 0.5%. Lipid-lowering medications were prescribed to 54.5% and 30.5% of potential and possible FH patients, respectively, but none of them achieved the therapeutic LDL-c target. Conclusion: Clinically diagnosed FH prevalence in Malaysian population is much higher than most of the populations in the world. At community level, FH patients are clinically under-detected, with majority of them not achieving target LDL-c level for high-risk patients. Therefore, public health measures are warranted for early detection and treatment, to enhance opportunities for premature CAD prevention. © 2021 Japan Atherosclerosis Society.