Cardiovascular disease mortality in familial forms of hypertriglyceridemia: A 20-year prospective study

Background-Familial combined hyperlipidemia (FCHL) and familial hypertrigly ceridemia (FHTG) are 2 of the most common familial forms of hyperlipidemia, There is a paucity of prospective data concerning the risk of cardiovascul ar disease (CVD) in such families. The purposes of this study were to estim ate 20-year total and CVD mortality risk among relatives in these families and to evaluate plasma triglyceride as a predictor of death. Methods and Results-The study was based on lipid and medical history data f rom 101 families ascertained in 2 studies conducted in the early 1970s, Vit al status and cause of death was determined during 1943 to 1997 for 685 fam ily members, including first-degree relatives of the probands and spouse co ntrol subjects. Compared with spouse control subjects, 20-year CVD mortalit y risk was increased among siblings and offspring in FCHL (relative risk 1. 7, P=0.02) after adjustment for baseline covariates. In FHTG families, the relative risk was also 1.7 but was not statistically significant (P=0.39). Baseline triglyceride was associated with increased CVD mortality risk inde pendent of total cholesterol among relatives in FHTG families (relative ris k 2.7, P=0.02) but not in FCHL families(relative risk 1.5, P=0.16) after ad justment for baseline covariates, Conclusions-This prospective study establishes that relatives in FCHL famil ies are at increased risk for CVD mortality and illustrates the need for ef fective prevention strategies in this group. Baseline triglyceride level pr edicted subsequent CVD mortality among relatives in FHTG families, adding t o the growing evidence for the importance of hypertriglyceridemia as a risk factor for CVD.