The importance of collecting a family history of severe cardiovascular diseases in children with familial hypercholesterolemia and dyslipidemia of other origins: A retrospective study

Background. Currently, cardiovascular diseases (CVD) retain their leading positions in the structure of morbidity and are not only the leading cause of mortality, but also the main factor in population disability. The main pathogenetic link in CVD of atherosclerotic genesis is atherogenic dyslipidemia. Familial hypercholesterolemia (FH) plays a special role. Identification of family history is a prerequisite for timely diagnosis and prevention of CVD.

Aim. To conduct a comparative analysis and quantitative assessment of the frequency of cardiovascular events among relatives of children suffering from FH, as well as dyslipidemia of other genesis (DOG).

Materials and methods. The study was conducted at the Bashlyaeva City Clinical Hospital of the Moscow Health Department from January 2022 to August 2024. The study included 1,163 children diagnosed with hypercholesterolemia of various origins. Of these, 446 children with FH and 717 children with DOG.

Results. When assessing the family history of 446 patients with FH, 161 children (36.1%) were identified whose relatives died as a result of acute cardiovascular events (ACVE) [n = 211]. 143 relatives of 127 patients (28.48%) with FH suffered ACVE but remained alive. As a result of the analysis of the family history, it was revealed that 71 relatives of 79 children (17.71%) with FH underwent surgery. The family history of relatives of patients (n = 717) with DOG showed that 160 relatives of 136 patients (18.97%) also died as a result of ACVE. 231 relatives of 193 patients (26.92%) with DOG suffered ACVE but remained alive. Surgical intervention was in the anamnesis of 30 relatives of 22 patients (3.07%) with DOG.

Conclusion. The study showed that 64.57% of patients with FH had relatives who suffered or died from ACVE, while in the group of individuals with DOG this figure was 45.89%. The frequency of ACVE among relatives of patients with FH was 18.68% higher than in the group of patients with DOG. These data indicate a higher expression of familial risk within FH compared to other forms of dyslipidemia. Thus, systematic analysis of family history in all children with hypercholesterolemia, regardless of its genesis, contributes to early identification of high-risk groups and allows timely implementation of preventive measures and prescription of targeted treatment.