Author(s): MARTÍN JÁIMEZ, M., GAVILÁN CARRERA, B., GONZÁLEZ BUSTOS, P., ORELLANA JAÉN, J., QUESADA JIMÉNEZ, L., SORIANO MALDONADO, A., VARGAS HITOS, J.A., Institution: UNIVERSIDAD DE ALMERÍA , Country: SPAIN, Abstract-ID: 2633

INTRODUCTION:
Familial hypercholesterolemia (FH) is a genetic disorder causing elevated LDL-c and increased cardiovascular risk (1). Many patients with FH fail to achieve LDL-C targets despite treatment (2), requiring complementary strategies to reduce their cardiovascular risk. Arterial stiffness, a marker of subclinical atherosclerosis, is an independent predictor of cardiovascular events (3), whereas physical fitness is a modifiable risk factor associated with a more favorable cardiovascular profile (4). Therefore, this study aimed to examine the association of cardiorespiratory fitness with arterial stiffness in patients with FH.
METHODS:
Forty-six adults with FH (20 men and 26 women; mean age 48.5±13.2 years) participated in this cross-sectional study. Cardiorespiratory fitness (CRF; maximal oxygen uptake [VO₂max] was assessed with the ramped Bruce protocol using a COSMED Quark CPET metabolic analysis system. Pulse wave velocity (PWV) was measured with the Mobil-O-Graph 24h PWV monitor as an indirect marker of arterial stiffness. Body mass Index (BMI), mean blood pressure and smoking status were registered. Linear regression analyzed the association of VO₂max with PWV. Three models were fitted: model 1 was a crude model; model 2 was adjusted for age, sex, BMI, mean blood pressure, and smoking; and model 3 included model 2 plus the cardiorespiratory fitness × age interaction.
RESULTS:
In crude analyses, higher VO₂max was associated with lower PWV (β=-0.532; p<0.001), although the association disappeared after adjustment for model 2 (p=0.784) due to the strong relationship of age with arterial stiffness (β=0.906; p<0.001). However, Model 3 revealed a significant CRF × age interaction (β=-0.386; B=-0.001; 95% CI: -0.002 to 0.000; p=0.003), indicating that higher CRF was associated with a lower increase in arterial stiffness for each additional year of age.
CONCLUSION:
Higher CRF was associated with lower age-related increase in arterial stiffness in patients with FH. These findings highlight the potential of CRF as a modifiable factor to mitigate vascular aging in FH. Future prospective studies and clinical trials are needed to establish causality and confirm the efficacy of fitness-based interventions in cardiovascular disease prevention for patients with FH.

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