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Non-coronary heart disease mortality and risk of fatal cancer in patients with treated heterozygous familial hypercholesterolaemia: a prospective registry study

Neil, HAW; Hawkins, MM; Durrington, PN; Betteridge, DJ; Capps, NE; Humphries, SE; Simon Broome Familial,; (2005) Non-coronary heart disease mortality and risk of fatal cancer in patients with treated heterozygous familial hypercholesterolaemia: a prospective registry study. ATHEROSCLEROSIS , 179 (2) 293 - 297.

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Abstract

Background: The prognosis from coronary heart disease (CHD) for patients with heterozygous familial hypercholesterolaemia has improved substantially since the introduction Of HMG Co-A reductase inhibitors (statins), but the effect of lipid-lowering drug therapy combined with dietary and life style advice on non-coronary mortality and the risk of fatal cancer is unclear.Methods: The cohort of 2871 patients was recruited from 21 outpatient lipid clinics in the UK front 1980 to 1998 and was followed for 221992 person-years. The standardised mortality ratio (SMR) was calculated from the ratio of the number of deaths observed to the number expected in the general Population of England and Wales.Results: There were 169 deaths, including 102 (60.4%) front CHID, and 32 (18.9%) from cancer. The SMR for CHD was 2.5-fold higher than in the general population (95% CI 2.1. 3.1), but the all-cause SMR was not increased (1.1, 95% CI 0.9, 1.3) and non-coronary mortality was significantly lower in men (0.5, 95% Cl 0.3, 0.7) and women (0.6. 95% CI 0.4, 0.9). The SMR for ail cancers was significantly reduced (0.6. 95% CI 0.4. 0.8) with an 80% reduction in fatal cancers of the respiratory and intra-thoracic organs and a non-significant reduction in fatal cancers of the genitourinary and digestive organs.Conclusions: Although the study cannot exclude the possibility that statins have anti-cancer activity, the results strongly suggest that living advice to consume a healthy diet, increase physical activity and stop smoking is associated with a substantial reduction in mortality from cancer. (c) 2004 Elsevier Ireland Ltd. All rights reserved.

Type:Article
Title:Non-coronary heart disease mortality and risk of fatal cancer in patients with treated heterozygous familial hypercholesterolaemia: a prospective registry study
Keywords:familial hypercholesterolaemia mortality, cancer, coronary heart disease, CHOLESTEROL, PLASMA
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Medicine (Division of) > Metabolism and Experimental Therapeutics
UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science

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