Is your high cholesterol genetic?
So many people are told high cholesterol and heart disease simply "runs in the family," so they shrug it off without a second thought. They're never told that a hidden cause of heart disease could be why. Genetic cholesterol disorders are very common, but almost never diagnosed.
The key is knowing what you’re dealing with.
That’s where we come in. The Family Heart Foundation aims to save generations of families from heart disease through timely identification and improved care. Through research, advocacy, and education we play a critical role in driving change and empowering families to navigate their health.
How at risk are you?
The quickest way to peace of mind is creating a plan of attack based on your risk factors. Find out about your family history of heart disease. If you learn early heart attacks and strokes run in your family, then take steps to understand why. Understanding the causes behind inherited heart conditions is the critical first step to living a heart healthy life.
Resources to help you understand heart health
CHOLESTEROL LEVELS →
EARLY SIGNS OF CARDIOVASCULAR DISEASE →
INHERITED HEART CONDITIONS →
LIVING WITH DISEASE AND STROKE →
LIFESTYLE AND HEART HEALTH →
THE ROLE OF MEDICATION →
Frequently Asked Questions
Eye color runs in the family. Hair type runs in the family. High cholesterol runs in the family, but that is not where the story ends. You can do something about it.
For many families, high cholesterol and early cardiovascular disease stem from genetic disorders – including familial hypercholesterolemia (FH) and elevated lipoprotein(a), or Lp(a).
FH or high Lp(a) is a diagnosis that comes with treatment, management, and advocacy. By sharing information among family members we can all save more families, more hearts.
It is important that you first understand your risk of inherited cardiovascular disease so that you can better manage it throughout your lifetime.
Knowing that your LDL cholesterol is high is a good start, but there is a lot more that goes into assessing your heart health. It’s important to look at your whole lipid panel including your triglycerides and HDL. In adults, triglycerides should be below 150 mg/dL. If they are elevated consider increasing your exercise, cutting down on alcohol when necessary, and restricting simple carbohydrates like cookies, cakes, ice cream, white rice, and white bread. As for HDL (also known as the good cholesterol) men’s levels should be above 40 mg/dL and women’s above 50 mg/dL. Low levels may be genetic, but there are some lifestyle measures that can improve HDL. You can consider increasing exercise, weight loss or quitting smoking.
You also want to think about whether you have other heart disease risk factors. The more risk factors the greater the cardiac risk. So, make sure you know your blood sugar level and your blood pressure numbers. Exercise regularly, eat a well-balanced diet and maintain an ideal body weight.
Also consider how long your LDL has been elevated. If you have genetically high LDL cholesterol, that’s different from gaining weight and having your LDL increase. With genetically high cholesterol, your level has been high since birth, so your heart (and other arteries) has been exposed to high cholesterol for a very long time. People who have genetically high LDL are at higher risk for early heart disease than people whose LDL increased later in life.
Finally, if you have high LDL cholesterol, it is also important for you to have your Lipoprotein(a) measured.
For some people, cardiovascular disease runs in their family because of exposure to bad habits such as cigarette smoking, sedentary lifestyle, and poor diet which can lead to high cholesterol, diabetes, obesity, and high blood pressure.
For other people, cardiovascular disease runs in their family because of genetics. Two genetic disorders that can lead to very early heart disease are familial hypercholesterolemia (FH) and elevated Lipoprotein(a), also known as Lp(a). To learn more about FH and Lp(a) click here.
To learn more about FH and Lp(a) click here.
FH is a genetic disorder that causes high levels of LDL cholesterol from birth. It affects approximately 1 in 250 people worldwide, but less than 30% of those with FH are diagnosed in the U.S. Early diagnosis and appropriate treatment lowers the risk of cardiovascular disease.
Lp(a) is the shorthand for Lipoprotein(a). Also referred to as “L-P- little-A.” It’s a very complex lipoprotein that appears to increase the risk for both heart disease and stroke when elevated. It can cause artery blockages, inflammation, and possibly clotting in arteries.
FH and high Lp(a) are practically invisible. Often, the first sign of either condition is a heart attack. Some individuals do have xanthomas, which are accumulations of cholesterol under skin by the Achilles tendon, knuckles, elbows, and/or knees. Some have xanthalasmas, deposits of cholesterol under the skin on the eye lids. Some individuals may develop corneal arcus, a white arc near the colored part of the eye.
FH can be clinically diagnosed with a lipid panel and a family history of early heart disease or stroke. FH is suspected when untreated LDL cholesterol levels are above 190 mg/dL in adults and above 160 mg/dL in those 20 years old and younger. FH can also be diagnosed with a genetic test which tests for common genes known to cause FH.
A Lipoprotein(a) test measures the level of Lipoprotein(a) in your blood through a simple blood test. It is not part of a standard lipid panel, so your clinician will need to order it directly if they suspect you may have high Lp(a). Generally, results over 50 mg/dL or 125 nmol/L are considered high and could increase an individuals’ risk for heart attacks and stroke.
Currently, FH is not curable, but it IS treatable. Now, more than ever, there are multiple treatment options for people with FH. Individuals with FH are not doomed to develop heart disease. They can lead normal lives, if diagnosed early and treated adequately. High Lp(a) is not curable either, and treatments are in trials. For now, people with high Lp(a) are advised to control all other risk factors like quitting smoking, eating healthy, exercising, and keeping their LDL at normal levels.
The Family Heart Foundation Care Navigation Center can help everyone no matter where they are in their journey. Our expert care navigator can help you find a specialist with knowledge of your situation. Visit the Care Navigation Center now.