1. Aortic compliance and plasma lipid and lipoprotein levels were measured in 20 young patients with heterozygous familial hypercholesterolaemia and in 20 age- and sex-matched control subjects.
2. Patients with familial hypercholesterolaemia had significantly higher plasma cholesterol, low-density lipoprotein-cholesterol and triacylglycerol levels than control subjects (P<0.001, P<0.001 and P<0.005, respectively). The patients with familial hypercholesterolaemia also had significantly more compliant (distensible) aortas than the control subjects (P<0.001), a significant inverse correlation being observed between compliance and age (r = −0.73, P<0.001) and between compliance and mean blood pressure (r = −0.60, P<0.005).
3. When the effects of age and sex on aortic compliance were corrected for, the blood pressure effect disappeared, significant correlations being observed between normalized compliance and cholesterol (r = 0.50, P<0.03), low-density lipoprotein-cholesterol (r = 0.54, P<0.01), high-density lipoprotein-cholesterol (r = −0.44, P<0.05), low-density lipoprotein-/high-density lipoprotein-cholesterol ratio (r = 0.60, P<0.006) and duration of disease (r = 0.67, P<0.002). Multivariate regression analysis showed that the low-density lipoprotein-/high-density lipoprotein-cholesterol ratio (P<0.03) and duration of disease (P<0.04) were the best predictors of normalized compliance.
4. We suggest that the measurement of aortic compliance in young patients with familial hypercholesterolaemia may potentially be a useful, noninvasive, research tool for assessing their susceptibility to atheroma.