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Barriers and shortcomings in access to cardiovascular management and prevention for familial hypercholesterolemia during the COVID‐19 pandemic

Huang, Helen, Leung, Keith S. K., Garg, Tulika, Mazzoleni, Adele, Miteu, Goshen D., Zakariya, Farida, Awuah, Wireko A., Yin, Elaine T. S., Haroon, Faaraea, Hussain, Zarish, and others. (2023) Barriers and shortcomings in access to cardiovascular management and prevention for familial hypercholesterolemia during the COVID‐19 pandemic. Clinical Cardiology, 46 (8). pp. 831-844. ISSN 1932-8737. (doi:10.1002/clc.24059) (KAR id:101500)


Familial hypercholesterolemia (FH) is a hereditary condition caused by mutations in the lipid pathway. The goal in managing FH is to reduce circulating low‐density lipoprotein cholesterol and, therefore, reduce the risk of developing atherosclerotic cardiovascular disease (ASCVD). Because FH patients were considered high risk groups due to an increased susceptible for contracting COVID‐19 infection, we hypothesized whether the effects of the pandemic hindered access to cardiovascular care. In this review, we conducted a literature search in databases Pubmed/Medline and ScienceDirect. We included a comprehensive analysis of findings from articles in English related and summarized the effects of the pandemic on cardiovascular care through direct and indirect effects. During the COVID‐19 pandemic, FH patients presented with worse outcomes and prognosis, especially those that have suffered from early ASCVD. This caused avoidance in seeking care due to fear of transmission. The pandemic severely impacted consultations with lipidologists and cardiologists, causing a decline in lipid profile evaluations. Low socioeconomic communities and ethnic minorities were hit the hardest with job displacements and lacked healthcare coverage respectively, leading to treatment nonadherence. Lock‐down restrictions promoted sedentary lifestyles and intake of fatty meals, but it is unclear whether these factors attenuated cardiovascular risk in FH. To prevent early atherogenesis in FH patients, universal screening programs, telemedicine, and lifestyle interventions are important recommendations that could improve outcomes in FH patients. However, the need to research in depth on the disproportionate impact within different subgroups should be the forefront of FH research.

Item Type: Article
DOI/Identification number: 10.1002/clc.24059
Uncontrolled keywords: familial hypercholesterolemia, cholesterol, genetics, atherosclerotic cardiovascular disease, mortality, COVID‐19
Subjects: R Medicine
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
SWORD Depositor: JISC Publications Router
Depositing User: JISC Publications Router
Date Deposited: 06 Jun 2023 11:16 UTC
Last Modified: 31 Aug 2023 15:16 UTC
Resource URI: (The current URI for this page, for reference purposes)

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