Sex differences in the perception of cardiovascular risk in familial hypercholesterolemia

•Females with FH are undertreated compared with males.•Sex differences in perception of FH as a disease was assessed in patients with FH.•We found no differences in the perception of ASCVD risk between males and females.•Females expressed more concerns about high LDL-C and safety of statins.•Physician's perception of ASCVD risk in males and females with FH is to be examined. Familial hypercholesterolemia (FH), a common genetic condition, is characterized by elevated low-density lipoprotein cholesterol (LDL-C) and premature atherosclerotic cardiovascular disease (ASCVD). Recent data indicate an undertreatment of females with FH. To characterize the role of sex in the perception of FH, its associated ASCVD risk and treatment. A survey investigating for sex differences in the perception of FH was sent to 1073 patients with FH using a cross sectional study design. A total of 412 patients (51.9 % male) responded to the survey; mean age was 56.2 ± 14.4 years. There was a higher proportion of males with ASCVD than females (41.5 % vs. 16.5 %, respectively, p