Familial hypercholesterolemia a risk factor for cerebral small vessel disease

Individuals with familial hypercholesterolemia (FH) appear to be at increased risk of lacunes and cerebral microbleeds, as reported in a study from Japan.

The study included 151 patients with FH who visited a lipid clinic and underwent brain MRI and 3,172 control participants who voluntarily underwent brain MRI as part of a checkup. Researchers used the neuroradiological findings to compare the prevalence and severity of cerebral small vessel disease between patients with FH and control participants.

Multivariable logistic and quasi-Poisson regression analyses were conducted to identify potential risk factors for cerebral small vessel disease.

FH showed an independent association with prevalent lacunes (adjusted odds ratio [aOR], 1.60, 95 percent confidence interval [CI], 1.03–2.51; p=0.039) and increased number of lacunes (1.67 times, 95 percent CI, 1.17–2.31; p=0.003).

Additionally, FH was independently associated with prevalent cerebral microbleeds (aOR, 9.42, 95 percent CI, 5.81–15.28; p<0.001) and an increased number of cerebral microbleeds (6.95 times, 95 percent CI, 4.34–10.83; p<0.001).

Patients with FH have elevated levels of low-density lipoprotein cholesterol from birth, and the findings of the present study warrant routine brain imaging for primary prevention of symptomatic stroke in this population, according to the researchers.