
Men with FH
There’s not one absolute answer to this question, but there are several likely reasons.
The first is puberty. As young men go through puberty, their HDL (the “good” cholesterol) tends to fall. This does not happen to young women, and low HDL is an additional risk factor for early heart disease.
There is also some evidence to suggest that women are protected from the symptoms of heart disease before menopause, probably because of estrogen.
Plus, in the past (not as much of an issue today) more men than women smoked. Smoking is poison for everyone, but for those with FH, smoking is doubly poisonous.
As long as your partner doesn’t have FH, each child you have has a 50% of having FH.
Another important risk factor to check is lipoprotein(a), also known as Lp(a). The only way to know if your Lp(a) is elevated is to have it measured with a simple blood test.
Studies show that approximately 1 in 5 people around the world have high Lp(a), so it is very common. Those living with FH who also have high Lp(a) are at even higher risk for early heart disease than those who only have a high LDL level.
This question can’t be answered precisely, but there is research to show that untreated, 25% of men and women with FH can expect their first heart attack in their early forties.
Thankfully, this is not a common problem, but if you have “statin intolerance” it can be miserable.
Studies show statins reduce chances of a future heart attack by 30%. For every 40 mg/dL LDL is reduced, cardiac risk falls by about 20%.
Before stopping your statin, it’s important to consider if another underlying condition is causing your pain. For example, those with an underactive thyroid are significantly more likely to experience pain from statins.
Certain medications can also contribute to these side effects. These include drugs used to treat HIV or certain antibiotics. These medications should not be taken with statins and should be discussed with your healthcare provider.
It’s also important to note that not all statins are created equal. Some are stronger than others and some react differently within the body. Discuss trying different statins, one at a time, with your healthcare provider to see if any reduction in side effects.
Page reviewed by Mary P. McGowan, MD, FNLA

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