It’s always a good time for you to take a closer look at all the different factors that can affect your heart health, but especially during February’s American Heart Month. You probably already know that controlling your cholesterol is important. But what about the link between genetics and high cholesterol? Explore everything you need to know about familial hypercholesterolemia (FH).
What is Familial Hypercholesterolemia?
FH is a genetic disorder that makes it more difficult for your body to remove LDL cholesterol from your blood. As you may know, LDL (low-density lipoprotein) is the “bad cholesterol” that leads to plaque buildup in the arteries. HDL (high-density lipoprotein) is the “good cholesterol” that helps to sweep away LDL buildup. When you have familial hypercholesterolemia, though, this process is out of balance. This puts you at higher risk for several conditions, from heart attack to stroke.
Risk factors of FH
Anyone whose family happens to carry this genetic mutation is at risk. But some populations are more likely to carry it than others. These include people whose family lineage is:
- Afrikaner
- Ashkenazi Jewish
- French Canadian
- Lebanese
In addition, you may be at higher risk if anyone in your family had a heart attack, bypass surgery, or a stent before age 55 (men) or 65 (women). The vast majority of people with FH are never diagnosed, so a family history of heart trouble may be your only clue.
Signs of genetics and high cholesterol
You could have familial hypercholesterolemia and not even know it. But many people with FH start to experience lumps under the skin. Known as xanthomas, these fatty deposits are particularly noticeable underneath the tendons of the hands, feet, and elbows, as well as under the eyes. In addition, if a routine screening shows elevated cholesterol levels, especially at a younger age, it may be worth investigating further.
Essential screenings
Everyone should have their cholesterol checked regularly, whether genetics and high cholesterol are a factor or not. In fact, the American Heart Association recommends a simple blood test for HDL, LDL, and triglycerides every four to six years beginning at age 20. Depending on your risk profile, you may need more frequent cholesterol checks. If your cholesterol is elevated at a young age, your doctor may recommend testing for FH.
Another essential screening is for lipoprotein (a). Although most family doctors do not perform this on everyone, it’s a key part of your EHE Pulse Physical exam. Lipoprotein (a) is a genetically inherited protein that carries cholesterol through the blood. Like LDL cholesterol, it can cause plaque to build up in your arteries, putting you at higher risk for stroke, heart attack, and other serious conditions. People with FH are more likely to also experience elevated lipoprotein (a).
Managing genetics and high cholesterol
Many people with FH struggle to keep their cholesterol levels in check with lifestyle management alone. Statins are a very common form of treatment. These medications block an enzyme in the liver that produces cholesterol, while also helping your body to more efficiently remove cholesterol. Like any medication, though, statins are not enough on their own. This is especially true if you also have elevated lipoprotein (a), as statins do not work against it.
Drug therapy should always be accompanied by an overall heart healthy lifestyle. Following the American Heart Association’s Essential 8 can help you live a long and healthy life:
- Improve your nutrition. Lowering your cholesterol begins with improving your nutritional intake. Eat a rainbow of fruits and vegetables along with lean proteins, whole foods, and healthy fats.
- Get physical activity. Adults need at least 150 minutes of moderate activity or 75 minutes of vigorous activity every week.
- Quit smoking. Tobacco raises your risk of all sorts of health problems. Keep in mind that vaping is just as dangerous for your health as smoking.
- Prioritize sleep. A lack of sleep is terrible for your body and mind. Most adults need 7 to 9 hours per night, and sleep deficits build over time.
- Control your weight. Each person has a different “set point,” or ideal body weight. Talk to your doctor to determine what’s best for you.
- Track your cholesterol. If you have FH, your doctor will likely want to perform frequent cholesterol checks. Knowledge is power, and tracking patterns allows you and your doctor to fine-tune both your medication and your lifestyle choices.
- Manage your blood sugar. High blood sugar levels over a long time can cause damage to your heart and other organs. If you have diabetes or prediabetes, keeping your blood sugar in check is imperative for your health.
- Monitor your blood pressure. Depending on your gender, age, and medical status, your blood pressure should be around 120/80. Higher blood pressure makes your heart work harder, so be sure to keep yours in a healthy range.
Familial hypercholesterolemia is a serious genetic condition that can make it extremely difficult to manage your cholesterol, especially if it is also paired with elevated lipoprotein (a). But there are active steps you can take to keep your cholesterol levels in check and live a long and healthy life. Work hand in hand with your doctor to develop a holistic, whole-body approach to managing your condition.