{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T18:13:23Z","timestamp":1788372803975,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T00:00:00Z","timestamp":1698883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["21AA2007"],"award-info":[{"award-number":["21AA2007"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Familial hypercholesterolemia (FH) is associated with atherosclerotic cardiovascular disease (ASCVD). However, the prevalence of FH among a general population remains unknown, and it is unclear if FH is associated with other cardiovascular complications, including heart failure (HF) and atrial fibrillation (AF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Analyses were conducted on individuals without a prior history of cardiovascular disease using a nationwide health claims database collected in the JMDC Claims Database between 2005 and 2022 (<jats:italic>n<\/jats:italic>\u2009=\u20094,126,642; median age, 44\u2009years; 57.5% men). We defined FH as either LDL cholesterol \u2265250\u2009mg\/dL or LDL cholesterol \u2265175\u2009mg\/dL under the lipid\u2010lowering medications under the assumption that lipid\u2010lowering medications reduced LDL cholesterol by 30%. We assessed the associations between FH and composite outcomes, including, ASCVD (myocardial infarction, angina pectoris, and stroke), HF, and AF using Cox proportional hazard model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 11,983 (.29%) FH patients. In total, 181,150 events were recorded during the mean follow\u2010up period of 3.5\u2009years. The status FH was significantly associated with composite outcomes after adjustments (hazard ratio [HR]; 1.38, 95% confidence interval [CI]: 1.30\u20131.47, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Interestingly, the status FH was significantly associated with HF (HR: 1.48, 95% CI: 1.36\u20131.61, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and AF (HR: 1.33, 95% CI: 1.08\u20131.64, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) in addition to angina pectoris (HR: 1.45, 95% CI: 1.33\u20131.58, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and stroke (HR: 1.19, 95% CI: 1.04\u20131.36, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found that the prevalence of FH was .29% in a general population. FH was significantly associated with a higher risk of developing cardiovascular disease, HF and AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Lay summary<\/jats:title><jats:p>We sought to identify the prevalence of FH among a general population, and to clarify whether FH increases the risk of not only ASCVD but also HF and AF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.14119","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T10:10:26Z","timestamp":1698919826000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Familial hypercholesterolemia is related to cardiovascular disease, heart failure and atrial fibrillation. Results from a population\u2010based study"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3357-1809","authenticated-orcid":false,"given":"Hayato","family":"Tada","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kanazawa University  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2553-6170","authenticated-orcid":false,"given":"Hidehiro","family":"Kaneko","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine The University of Tokyo  Tokyo Japan"},{"name":"The Department of Advanced Cardiology The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Suzuki","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine The University of Tokyo  Tokyo Japan"},{"name":"Center for Outcomes Research and Economic Evaluation for Health National Institute of Public Health  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Prevention of Diabetes and Lifestyle\u2010Related Diseases, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norifumi","family":"Takeda","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhito","family":"Fujiu","sequence":"additional","affiliation":[{"name":"The Department of Cardiovascular Medicine The University of Tokyo  Tokyo Japan"},{"name":"The Department of Advanced Cardiology The University of Tokyo  Tokyo 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