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A newer study published in Atherosclerosis in the end of 2011 looked at standardized mortality ratios according to the same concept of maternal and paternal inheritance of FH. As shown in the Figure, males in general seem to do worse than females. However looking at those who inherit based on maternal processes as opposed to paternal processes, women who inherit FH through the mother have as much, if not greater, risk than a male who inherits FH from the father.
This is an important concept, because it highlights that while FH is generally viewed as being a condition that presents almost a decade later in women than in men, if women inherit the condition through the mother it may be necessary to think of them presenting with the disease more aggressively and perhaps sooner in life.
[33] Adapted from: J. Versmissen et al. Atherosclerosis 2011; 219: 690–693.