Abstract
Background and aimsWomen with heterozygous familial hypercholesterolemia (FH) are recommended to initiate statin treatment at the same age as men (from 8 to 10 years of age). However, statins are contraindicated when pregnancy is planned, during pregnancy and breastfeeding. The aim of the study was to determine the duration of pregnancy-related off-statin periods and breastfeeding in FH women. MethodsA cross-sectional study using an anonymous online self-administered questionnaire was conducted. Women with FH were recruited through Lipid Clinics in Norway and Netherlands and national FH patient organizations. Results102 women with FH (n = 70 Norwegian and n = 32 Dutch) were included in the analysis. Total length of pregnancy-related off-statin periods was estimated for 80 women where data were available, and was median (min-max) 2.3 (0–14.2) years. Lost statin treatment time was estimated for 67 women where data were available, and was median (min-max) 18 (0–100)% at mean (SD) age of 31 (4.3) years at last pregnancy. More women breastfed in Norway (83%) and for longer time [8.5 [1-42] months] compared to the Netherlands [63%, p = 0.03; 3.6 (0–14) months, p < 0.001]. Eighty-six percent of the women reported need for more information on pregnancy and breastfeeding in relation to FH. ConclusionsYoung FH women lose years of treatment when discontinuing statins in relation to pregnancy and breastfeeding periods and should be closely followed up to minimize the duration of these off-statin periods. Whether these periods of interrupted treatment increase the cardiovascular risk in FH women needs to be further elucidated.
Highlights
Familial hypercholesterolemia (FH) is an autosomal dominant dis ease causing elevated plasma levels of low-density lipoprotein choles terol (LDL-C) from the first years of life [1]
The cholesterol burden accumulates through life and defines the risk of cardiovascular disease (CVD) [2], underlining the importance of early treatment start and lifelong treatment to reduce the risk of premature CVD in these patients [3,4]
The primary aim of the present study was to examine and estimate the duration of pregnancy-related off-statin periods and breastfeeding in Norwegian and Dutch familial hypercholesterolemia (FH) women, and whether the duration of breast feeding was influenced by a wish to restart treatment
Summary
Familial hypercholesterolemia (FH) is an autosomal dominant dis ease causing elevated plasma levels of low-density lipoprotein choles terol (LDL-C) from the first years of life [1]. Female heterozygous FH patients are recommended to be considered for statin treatment at the same age as men (8–10 years) [5, 6]. Current ESC/EAS Guidelines recommend that lipid-lowering drugs are discontinued when pregnancy is planned, during pregnancy and during the breastfeeding period (pregnancy-related off-statin periods) [4,5]. Conclusions: Young FH women lose years of treatment when discontinuing statins in relation to pregnancy and breastfeeding periods and should be closely followed up to minimize the duration of these off-statin periods. Whether these periods of interrupted treatment increase the cardiovascular risk in FH women needs to be further elucidated
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call