Sex Differences in Familial Hypercholesterolemia

Marianne Klevmoen, Janneke W.C.M. Mulder, Jeanine E. Roeters van Lennep, Kirsten B. Holven*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

3 Citations (Scopus)
10 Downloads (Pure)


Purpose of Review: 

This review aims to summarize the existing research on sex differences in familial hypercholesterolemia (FH) across the lifespan. 

Recent Findings: 

From childhood onward, total- and low-density lipoprotein cholesterol (LDL-C) levels in girls are higher than those in boys with FH. By the age of 30 years, women with FH have a higher LDL-C burden than men. In adulthood, women are diagnosed later than men, receive less lipid-lowering treatment, and consequently have higher LDL-C levels. An excessive atherosclerotic cardiovascular disease risk is reported in young female compared to male FH patients. The periods of pregnancy and breastfeeding contribute to treatment loss and increased cholesterol burden. 


Earlier initiation of treatment, especially in girls with FH, and lifelong treatment during all life stages are important. Future research should aim to recruit both women and men, report sex-specific data, and investigate the impact of the female life course on cardiovascular outcomes. Future guidelines should include sex-specific aspects. 

Graphical abstract: 

[Figure not available: see fulltext.].

Original languageEnglish
Pages (from-to)861-868
Number of pages8
JournalCurrent Atherosclerosis Reports
Issue number11
Publication statusPublished - Nov 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s).


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