Having high blood cholesterol is sort of like having high blood pressure – they both have few if any symptoms, each can increase your risk of a heart attack or stroke, and both can be genetically inherited. Yet, do you know your risk for high cholesterol and does it run in your family?
Coronary Artery Disease is the leading cause of death in men in the United States. Unless men have their cholesterol checked with a blood test, they will not know if their level is high. They also won’t know if they have a hereditary condition called Familial Hypercholesterolemia (FH).
What is cholesterol and what is its purpose?
Cholesterol is a type of fat made in the liver that’s vital to human life. Cholesterol serves three main purposes:
- It helps the production of sex hormones – estrogen and testosterone
- It aids in building human tissues
- It takes part in the bile production in the liver
Our body makes about 80% of the cholesterol while the other 20% comes from foods containing it. Animal sources, such as beef, poultry, fish, egg yolks, and milk, are the only food sources of cholesterol – no plant-based food (vegetables, fruits, grains, nuts, beans) contain cholesterol.
What’s the danger of Familial Hypercholesterolemia?
When a person has FH, the liver will be unable to remove cholesterol from the body. Therefore, cholesterol made from the liver will buildup excessively in the blood vessels leading to life-threatening heart attacks, coronary disease, and strokes.
8 facts to know if you have Familial Hypercholesterolemia
1. To know if you have FH, you need a blood test
Most people will not know if they have FH due to a lack of symptoms. By the time symptoms appear, you are already in danger of having a cardiovascular event such as a heart attack. The American Heart Association recommends having your doctor run a comprehensive cholesterol-screening to show your levels of high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides to determine if you have FH. The main symptoms of FH will be high blood cholesterol and a family history of high cholesterol.
2. There are some symptoms with very high levels of high cholesterol
Some individuals with extremely high cholesterol caused by FH can have excess cholesterol deposited in lumps or bumps around knuckles, elbows, and knees, or as yellowish areas or a white ring around the cornea of the eye sometimes seen in those under the age of 45. Swollen or painful Achilles tendons may also be symptoms of high cholesterol.
3. How common is FH in the United States?
It affects 1 in 400 people in the general population. It’s more common than other genetic diseases that get a lot more airtime. Some populations, such as French Canadian and Ashkenazi Jewish populations, have rates of FH of 1 in 100 people.
4. Is FH inherited by all the children in a family or only some of them?
FH is a condition beginning at birth – cholesterol is high from day one in patients with FH. If a parent has FH, there’s a one-in-two chance that a child will have it or a 50 percent likelihood of inheriting the form of FH known as Heterozygous FH. If both parents have it, then a child has a 25 percent chance of inheriting the more serious form of the disorder, known as Homozygous FH.
5. Knowing family medical history is important
If a family has a pattern of heart attacks or heart disease (in men before age 55 or in women before age 65), it is recommended that children in the family undergo cholesterol testing between ages 2-10.
6. The rate of a person with FH having heart disease is 20 times higher than people without FH
According to the National Human Genome Research Institute, men with FH are likely to have heart attacks or even strokes between the ages of 40-50, and about 85 percent of men with FH will have a heart attack by age 60. Women with FH have an increased risk for heart attack at age 50-60.
7. How is high cholesterol treated in individuals with inherited high cholesterol?
Physicians will encourage a heart-healthy lifestyle which includes regular exercise, following a low-fat diet, and not smoking. While lifestyle changes are recommended, they are not enough to lower hereditary high cholesterol. The cornerstone of treating FH is statin medications. Other medications will also be needed such as PCSK9 inhibitors such as Praluent can reduce the amount of LDL cholesterol in circulation and lower total cholesterol. Patients with FH should be referred to a physician knowledgeable in this condition to determine the best treatment plan for them.
8. The good news is high cholesterol is controllable
When someone with FH follows a heart-healthy diet, exercise does not smoke, manages their weight, takes necessary medications, and sees their physician for regular blood lipid checks, it can help keep cholesterol levels under control reducing the risk for a heart attack or stroke.