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Although the genetic prevalence of FH does not differ between sexes, women with FH face unique challenges across their lifespan that contribute to their cardiovascular risk. This review synthesizes current evidence on the trajectory of FH in women, with a focus on disparities in diagnosis, treatment, and cardiovascular outcomes across the female lifespan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recent Findings<\/jats:title>\n                    <jats:p>Current evidence highlights a substantial gender gap in FH care. Compared with men, women are typically diagnosed 3\u20137 years later, are 26% less likely to receive lipid-lowering therapy (LLT), and are 37% less likely to achieve guideline-recommended LDL-C targets. Childbearing years are a major vulnerable period, as LLT is usually interrupted during pre-conception, pregnancy, and lactation, resulting in a median loss of 2.3 years of statin-treatment per woman. These treatment-gaps contribute to a disproportionately greater cumulative LDL-C burden in younger women with FH than men. Although premenopausal women retain lower absolute ASCVD risk than men with FH, their excess risk relative to the general female population exceeds the corresponding male disadvantage, and both LDL-C and ASCVD risk rise further after menopause.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Women with FH face distinct diagnostic and therapeutic challenges requiring sex-specific care. Improving equity in FH care in women necessitates early diagnosis, appropriate LLT intensification, dedicated management across the childbearing years, and expanded research into LLT safety in pregnancy to reduce cumulative LDL-C exposure and long-term ASCVD burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11883-026-01431-1","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T07:31:19Z","timestamp":1780903879000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Familial Hypercholesterolemia in Women: Diagnosis, Treatment, and Cardiovascular Outcomes Across the Lifespan"],"prefix":"10.1007","volume":"28","author":[{"given":"Irene","family":"Karungi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten B.","family":"Holven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kausik K.","family":"Ray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amany","family":"Elshorbagy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"issue":"10312","key":"1431_CR1","doi-asserted-by":"publisher","first-page":"1713","DOI":"10.1016\/S0140-6736(21)01122-3","volume":"398","author":"Global perspective of","year":"2021","unstructured":"Global perspective of. familial hypercholesterolaemia: a cross-sectional study from the EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC). 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KBH reports lecture fees\/honoraria from Ultragenyx, Menarini, Amgen, and Sanofi. KKR reports unrestricted research grants (last 3 years) to Imperial College London from Amgen, Sanofi, Regeneron, Daiichi Sankyo, and Ultragenyx; Consulting fees from Novartis, Daiichi Sankyo, Kowa, Esperion, Novo Nordisk, MSD, Lilly, Silence Therapeutics, AZ, New Amsterdam Pharma, Bayer, Beren Therapeutics, CLEERLY, EMENDOBIO, SCRIBE, CRISPR, VAXXINITY, Amarin, Regeneron, Ultragenix, Cargene, Resverlogix for serving as a member of the SC or EC of clinical trials and roles as PI, NLI. Attending advisory boards, providing advice on data, its interpretation and future lines of research; lecture fees from Novartis, BI, AZ, Novo Nordisk, Viatris, Amarin, Biologix Pharma, Sanofi, Amgen, Esperion, Daiichi Sankyo, Macleod Pharma for CME and non-CME symposia at international meetings and stock options from New Amsterdam Pharma and PEMI31. AE has participated in research grants to Imperial College from Amgen, Regeneron, Daiichi Sankyo, and Ultragenyx. c) Human and animal rights and informed consent This review does not contain any studies with human or animal subjects performed by any of the authors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This review does not contain any studies with human or animal subjects performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and Animal Rights and Informed Consent"}}],"article-number":"61"}}