9 Things you Need to Know About Inherited High Cholesterol

If you have high cholesterol, many factors may be contributing to the cause. High cholesterol is linked to poor nutrition, insufficient exercise and smoking. This can increase the risk of developing heart disease. The Centers for Disease Control and Prevention states that heart disease ranks as the number one cause of death in America.

However, what if you are already at risk of being born?

Family hypercholesterolemia (or FH) is an inheritable form of high cholesterol. It can also be called familial high cholesterol. FH can be present from birth. It causes more cholesterol than your body can tolerate.

Are you or someone you know suffering from FH? Here's nine important things to remember.

Cholesterol Does Not Kill Your Body Cholesterol does not kill the body. Cholesterol is essential for healthy cells. Your liver has the responsibility of making all your cholesterol. There are two types of cholesterol, high-density and low-density.

Leslie Cho MD is the Cleveland Clinic Women's Cardiovascular Center director. "HDL or happy cholesterol can be a great way to remember which types are available." Then, there's bad cholesterol known as LDL (L for poor).

HDL absorbs cholesterol, carries it to the liver and flushes it out. LDL, which makes up most of the cholesterol found in your body, builds up plaque along the walls of blood vessels and restricts blood flow to your heart.

FH plays a trick on the Liver. FH can be caused by defective LDL receptors, which are unable to cycle cholesterol from bloodstream through liver.

This is only one aspect of the problem. FH convinces your liver that you aren't getting enough cholesterol. The liver then makes more and sends signals to your intestine telling it to absorb even more cholesterol.

People with FH have a difficult time lower ing their cholesterol. There is no way to stop your liver producing more cholesterol, regardless of how much you exercise or eat.

It's a Family Affair If a parent has familial hypercholesterolemia, there is a 50 percent chance a child will inherit the LDL abnormality, known as heterozygous FH.

Rarely, both parents may have FH. In these cases homozygous FH is the highest form of high cholesterol.

Cascade screenings can be performed by cardiologists to decrease guesswork. This means that they will screen every first-degree relative of the initial FH patient.

I think of my patients who have the most severe forms of this disorder. James Underberg MD is a medical assistant professor at NYU Grossman Medical School in New York City. He also serves as president of National Lipid Association.

Dr. Underberg explained that she is taking care to the family and keeping the patient's health in good condition. "I take care of any children who might also be affected by the disease. Our main focus is to care for the families of patients."

The symptoms are mild and rare. FH is not a common condition. This makes it dangerous to go undiagnosed.

However, some people develop small lumps or bumps in their eyes from cholesterol deposits.

A corneal arcus, which is a white circle around the cornea that appears in some people under 45 years old, can also be noticed. It appears most commonly as a half moon on either the top or bottom of your cornea. If it is hidden under your eyelids, you may not be able to see it.

Dr. Cho suggests that the easiest way to find out if your cholesterol levels should be checked is to examine your family history.

According to the CDC more people have FH than you think. More than a quarter of Americans are suffering from high cholesterol and 1 in 200 adults in America is affected. This means that approximately 1.3 million Americans have FH.

FH is often diagnosed in isolated communities such as Ashkenazi Jews or Dutch Afrikaners. These people have a higher chance of passing FH to others.

Underberg asserts that FH has no effect on any race, ethnicity or gender in any way. Researchers found in Circulation, May 2020 that 60% of FH studies were from Europe and that over 80 percent are reported from FH patients. There is no evidence of FH in Southeast Asia or Africa.

FH may not be diagnosed and treated in time. FH patients are at 20 percent greater risk for developing early-stage heart disease, according the American Heart Association. The risk of stroke and peripheral vascular disease in patients is also higher than that for the rest.

Untreated FH means that half of men will experience a heart attack by the age 50. Some may even have it as young as 20. According to the American Heart Association, 30 percent of women with untreated coronary heart disease will experience a heart attack by age 60.

FH is Treatable Although it's not possible to cure familial hypercholesterolemia by living a healthy life, this lifestyle should be encouraged. It means eating a low-fat diet such as the Mediterranean or plant-based, with 30 minutes of moderate exercise per day, including running, biking, walking or other activities that keep you active. You should also stop smoking, drinking alcohol and other bad behaviors.

Statin medication is another option for FH. Praluent and Zetia are two examples of PCSK9-inhibitors that can lower total cholesterol. Ezetimibe (Zetia), on the other hand, decreases intestinal cholesterol absorption. And bile acid sequestrants such as cholestyramine and colestipol lower LDL cholesterol.

Adenosine triphosphate citrate lyase inhibitors (ACL), are another class of drugs which work by inhibiting the production cholesterol in the liver. They are prescribed to prevent high cholesterol levels in heterozygous FH patients. The only ACL inhibitor that the U.S. Food and Drug Administration approved for reducing LDL cholesterol is bempedoic acid (Nexletol).

Some people have high cholesterol and medication is not effective. A nonsurgical treatment called LDL apheresis, which is similar to dialysis, can be used to eliminate cholesterol from the blood every two weeks.

In a July 2018 Frontiers in Pharmacology study, 14 options were identified for FH. They ranged from diet and fish oil to genetic therapy. The study also showed that children and adults need to receive the same treatments. The majority of FH patients will receive some form of treatment.

Cho says that exercise and a healthy lifestyle are beneficial for everyone. Cho says that just because cholesterol medication is being taken doesn't mean your diet has to be restricted. You can still eat what you like. You are all connected.

Treatment of young children is acceptable. Medical treatment for any type of condition should not be considered as an option. FH is best treated as soon as possible.

According to a Journal of the American Heart Association, universal lipid screening for children is advised as soon as possible for people with high cholesterol. For everyone else, screenings should take place between ages 9 and 11. These recommendations have been adopted by only one-third (or 3%) of the practicing pediatricians. However, earlier detection can reduce the need for medication and treatments.

Statins can be effective for children who need more complex treatment, according to the FDA approved study. Pitava statin and Prava statin have been approved for children aged 8 or older. The FDA has also approved five of the other statins currently on the market starting at age 10.

Underberg believes that early treatment and diagnosis are more important than waiting for a vehicle to fail to work.

Underberg states, "It's exactly the same as cholesterol management in these patients." If you address it early, the children will be less likely to develop the disease later on.

FH is now more well-known than ever before. Reputable organizations like the American Heart Association, advocacy groups such as the Family Heart Foundation or Underberg's National Lipid Association have a commitment to inform and study FH via continuing research. This has already increased our knowledge considerably.

Underberg states, "I think the last ten years has been really a boom period for FH awareness. Part of this is because there have been new therapies." "I've witnessed this disease change from something that would kill you before you were 15 years old to something you can enjoy a long life if it is treated properly and early."