How to fight genetically inherited high cholesterol

Many adults don’t worry about cholesterol until they are about age 55. But for some people, a genetic mutation called familial hypercholesterolemia (FH) can put them at risk of dying from a heart attack even younger than that. 

After all, 90% of people with FH have not been diagnosed yet since many people don’t realize they have the condition until the buildup of bad cholesterol begins to have negative health consequences. 

What is FH? 

FH is a genetically inherited condition that makes it harder for the body to remove bad cholesterol. If you have one parent with this genetic mutation, you have a 50% chance of also having the mutated gene.  

If you have two parents with FH, you also have a 50% chance of receiving the gene but also are more at risk of developing a more severe form of FH called homozygous familial hypercholesterolemia (HoFH). HoFH can strike as early as childhood and is significantly more resistant to treatment.  

To ensure you address the condition early, it’s important to understand what cholesterol is.

Good cholesterol is known as high density lipoprotein (HDL). Lipoproteins deliver the fat and cholesterol the body needs to keep its energy and maintain its cellular structure. High density lipoproteins pass easily through the bloodstream, collecting excess cholesterol and delivering it to the liver to be processed and removed from the body. 

Low density lipoprotiens (LDL), or bad cholesterol, does not travel through the bloodstream as easily but instead collects along the walls of arteries as plaque. Over time, this restricts blood flow and can eventually create a life-threatening situation. 

Overall, the ideal total cholesterol level is about 150 mg/dL, according to the American Heart Association. It also recommends an LDL of 100 mg/dL or lower.  

“In families with FH, it’s common for close family members to have markedly elevated cholesterol, typically a total cholesterol over 300 mg/dL or much higher,” explains Dr. Robert Johnson, a cardiologist at Advocate Health Care. “Typically, the LDL is over 200 mg/dL and sometimes much higher. There is also often a strong history of premature coronary artery disease. This family history should certainly be reviewed with a primary care provider so the genetic condition can be identified and properly managed.” 

So, what should you do if you have FH? 

Fortunately, there still is hope for good health if you have FH. 

“All patients with FH will require pharmacologic therapy along with a very low-fat diet and regular exercise. Depending on the degree of LDL elevation, patients with FH might develop coronary artery disease in their 20s. So, it’s important to make lifestyle modifications early on.”

Lifestyle modifications that can help lower your cholesterol include:

• Improving your diet. Reduce the amount of saturated fats and cholesterol-rich foods in your diet and try eating more fiber. Fruits, vegetables, nuts and whole grains are sources of phytosterols, which compete with cholesterol for absorption in your body. When phytosterols are absorbed, it makes it easier for the body to remove bad cholesterol instead.
• Getting regular exercise. This increases good cholesterol and improves blood flow, expediting the removal of bad cholesterol from the bloodstream. Physical exertion also requires cells to be repaired and maintained, allowing for more cholesterol to be utilized as intended.
• Quitting smoking. Smoking tobacco encourages bad cholesterol to stick to arterial lining, exacerbating the threat FH possesses, like heart attacks.

Want to learn more about your risk for heart disease? Take a free online quiz.