As we mark World Obesity Day, it's important to recognise that obesity isn't just a matter of appearance or lifestyle—it's a significant risk factor for heart disease, even among those whose heart disease risk is mainly driven by genetically high cholesterol.
Approximately one in three hundred (1:300) people has familial hypercholesterolaemia (FH), the most common monogenic disorder. In these individuals, a genetic defect in cholesterol uptake leads to lifelong elevation of low-density lipoprotein (LDL)cholesterol, and, hence, an increased risk of heart disease. A study conducted by Dr Amany Elshorbagy, on behalf of the FH Studies Collaboration (FHSC) Investigators, sheds light on the relationship between obesity and atherosclerotic cardiovascular disease (ASCVD) in individuals with heterozygous FH (HeFH). This study, published as a congress abstract in the Atherosclerosis Journal, involved over 35,000 patients with HeFH across 50 countries from 6 continents.
The researchers aimed to determine the prevalence of overweight and obesity among these individuals and whether they pose additional risks for ASCVD beyond their high cholesterol levels.
They found that, globally, more than half of adults and over a quarter of children with HeFH were either overweight or obese. The prevalence was particularly high in Northern Africa and Western Asia, highlighting a health concern.
Importantly, the study found that obesity was associated with a more atherogenic lipid profile, indicating a higher likelihood of plaque buildup in the arteries, even when individuals were on lipid-lowering medication. Obesity was linked to a significantly higher likelihood of coronary artery disease and stroke in adults, and coronary artery disease in children. These associations remained even after controlling for other risk factors such as diabetes, hypertension, and smoking.
This suggests that obesity exacerbates the already augmented risk of heart disease in people with HeFH.
The findings from this study are briefly explained in a podcast by Medical Digest, and a press article by Medscape, with commentary from other experts in the field.
It underscores the critical importance of weight management, even in individuals whose cardiovascular risk is primarily driven by genetic cholesterol elevation. While medications can help control cholesterol, addressing obesity is also vital in reducing the risk of heart disease in this population.
Sustained efforts to maintain a healthy weight through a balanced diet, regular exercise, and lifestyle modifications are imperative for all. By prioritising weight management, we can mitigate the risk of heart disease not only in the general population but also in those with genetically high cholesterol levels.
Prepared by Dr Amany Elshorbagy
To learn more about obesity, and the links between obesity, childhood obesity and genetically high cholesterols check out the resources below.
This research by EAS FHSC and Dr Amany Elshorbagy adds to the existing body of evidence which suggests that early screening and detection are key to preventing lasting health implications. It also ties in very strongly with our ongoing efforts to engage political support and to build synergies to successfully tackle CVD risk factors, as early as possible, starting in childhood.
On the occasion of the World Obesity Day, we also wish to bring to your attention the Zagreb Declaration.
The Zagreb Declaration, adopted on 10 May 2023, sets out a political roadmap for reversing the rapid rise of childhood obesity. It acknowledged the importance of raising awareness about obesity and how this issue affects children and future generations and recognized the necessity of leadership and advocacy to accelerate actions to stop childhood obesity at national and international levels on all concerned platforms and relevant international fora.
Back in 2022, we published the Prague Declaration on FH paediatric screening and preventing the preventable.
For more information on obesity and the world awareness campaign, check out https://www.worldobesityday.org/.
Learn more about the updates from EAS FHSC and the EAS 2023 congress by watching our webinar, where Dr Amany Elshorbagy explained her research https://www.youtube.com/watch?v=PAwXf6cO6sk.
Reference:
Elshorbagy A, et al. Global prevalence of overweight and obesity among paediatric and adult patients with homozygous or heterozygous familial hypercholesterolaemia, and association with coronary artery disease. Atherosclerosis 2023; 379 Supplement: S15. DOI: https://doi.org/10.1016/j.atherosclerosis.2023.06.925.
Yesterday, February 20th, our very own Patient Ambassador and Community Engagement Manager, Emma Print represented the patients’ perspective on a multidisciplinary panel at a virtual event hosted by the European Federation of Pharmaceutical Industries and Associations (EFPIA).
The virtual event highlighted the importance of having national cardiovascular plans that included secondary prevention measures. It featured insights from different stakeholders in the context of a recently published report by the London School of Economics (LSE), offering an invaluable opportunity to understand the practical applications of this research. The panellists included a patient, (Emma Print), a researcher (Panos Kanavos, Associate Professor of International Health Policy at the LSE), a politician (Tomislav Sokol, Member of the European Parliament, EPP Group, Croatia), and an industry representative (Haseeb Ahmad, President of Novartis Europe).
Cardiovascular disease remains the number 1 killer in Europe, costing the EU 282 billion euros per year. In addition to mortality, morbidity and cost, the experience of a heart attack or stroke can also have a profound and lasting impact on the quality of life of those affected, as well as their families or carers.
The report, commissioned by the EFPIA Cardiovascular Health Platform, demonstrates that if 70% of people living with cardiovascular disease could have their risk factors better managed, 1.2 million deaths in the EU could be averted over the next ten years. For example, reducing LDL-cholesterol levels by just 1 mmol/L has been shown to reduce all-cause mortality by 10%.
You can access the report here.
For the recording of the event please visit: https://efpia.eu/news-events/events/efpia-event/getting-to-the-heart-of-the-matter-improving-cardiovascular-health-in-europe/
We are pleased to welcome Gráinne Crowley to our team as FHEF Partnerships and Development Lead, starting today, February 1st, 2024. Gráinne brings over 15 years of experience in patient advocacy and health policy, working within the biotech industry. Before joining the pharma industry, Gráinne was an EU policy advisor for a leading independent research charity and worked as a Principal Consultant for a Public Affairs company advising companies, trade associations and NGOs on EU policy and engagement. She is a former co-chair of EuropaBio’s Patient Engagement Forum and participated in IMI projects with a specific focus on enhancing patient involvement in R&D. In her spare time, she enjoys rediscovering her home country (Ireland), water sports and is an avid rugby fan.
In her role as Partnerships and Development Lead, Gráinne will be responsible for developing and fostering meaningful relationships with the wider health industry, including life sciences, MedTech, diagnostics as well as the emerging players in the health innovation space, which share a common mission with FHEF, to further our Foundation’s aims and objectives. Moving on, Gráinne will lead the Industry Roundtable, while ensuring all our activities are in line with the governing compliance and ethics rules as well as agreements in place between FHEF and our Industry Partners.
This is an important step for our growing organisation. It demonstrates FH Europe Foundation’s commitment to building robust, compliant, and transparent collaboration with the life sciences players. We are entering an important phase with our foundation, with projects and initiatives which have the potential to shape the future of the patients and their families we represent as well as the wider familial dyslipidaemias community.
A warm welcome to the Team and the FH Europe community, Gráinne!
'We look forward to building on Gráinne’s rich experience and knowledge, to help improve our ongoing interactions with the existing industry partners by ensuring they are built on strong and transparent foundations, while we expand our partnerships and collaborations with new partners. Those are exciting times at FHEF, and we need to ensure, that whatever we do, we bring the best outcomes to our network, patients, their relatives and families, and the citizens, within the right framework.' – said Magdalena Daccord, Chief Executive of FH Europe Foundation.
'I am really thrilled to be part of the FH Europe Foundation and to work with its dynamic and passionate team. I know I will learn a tremendous amount from my new colleagues while, at the same time, have the opportunity of staying in touch with former ones. I look forward to continuing to support meaningful partnerships between the patient community, industry and other stakeholders but from a new and exciting perspective' said Gráinne.
If you would like to connect with Gráinne to join FH Europe Foundation roundtable of industry partners, to explore opportunities to be part of the Lp(a) International Taskforce or any other collaboration and initiatives, please contact her via email gc@fhef.org.