Familial hypercholesterolemia mutations in the Middle Eastern and North African region: A need for a national registry

•Familial hypercholesterolemia (FH) is severely underdiagnosed in Middle Eastern and North African (MENA) countries.•FH mutations are not well reported in MENA compared with Western countries.•FH registry will decrease the health and economic burden of FH in the MENA region.•Awareness would be key in the building of MENA FH registry.

BackgroundFamilial hypercholesterolemia (FH) is a well-understood Mendelian disorder that increases the risk of cardiovascular disease (CVD), a leading cause of mortality in Middle Eastern and North African (MENA) countries.ObjectiveReview the reporting status of FH mutations across MENA and propose a systemic and strategic method for building a MENA FH registry.MethodsSystematic literature search for statistics pertaining to CVD and comparison of number of FH mutations reported in MENA countries and countries with established FH registries.ResultsOnly 57 mutations were reported in 17 MENA countries, whereas more than 500 mutations reported in 3 Western countries. Mortality rates due to CVD were significantly higher in MENA countries compared with Western countries.ConclusionsThe relatively low reporting of FH mutations in the consanguineous MENA communities with higher prevalence of CVD indicates poor awareness of CVD genetic risk and warrants a registry to prevent premature CVD due to FH. This registry will help in identifying novel and reported FH mutations, all of which will have clinical and research benefits in MENA countries.