Unlocking the mystery: 8 Essential insights into hereditary high cholesterol

High cholesterol, much like high blood pressure, often lurks without symptoms, silently elevating the risk of heart attack or stroke. But did you know that this condition can be inherited and go undetected? Here are eight crucial facts about hereditary high cholesterol you need to know:

What’s Cholesterol and Its Purpose?

Cholesterol, a fatty substance primarily produced in the liver, plays essential roles in hormone production, tissue building, and bile production. While our bodies generate about 80% of cholesterol, the remaining 20% comes from cholesterol-rich foods, predominantly animal sources such as beef, poultry, fish, egg yolks, and whole milk.

The Danger of Familial Hypercholesterolemia (FH)

In FH, the liver fails to efficiently remove cholesterol, leading to dangerous accumulations in blood vessels. This buildup significantly increases the risk of heart attacks, coronary disease, and strokes.

Diagnosing FH

FH often lacks noticeable symptoms, necessitating a comprehensive cholesterol screening, as recommended by the American Heart Association. High blood cholesterol levels and a family history of the condition are key indicators.

Symptoms of High Cholesterol

Extreme cases of high cholesterol, particularly those caused by FH, may manifest as visible signs such as cholesterol deposits around joints such as knuckles, knees, and elbows, or a distinctive ring around the cornea. Swollen Achilles tendons can also signal elevated cholesterol levels.

Prevalence of FH

In the United States, FH affects approximately 1 in 400 individuals in the general population, making it more common than other genetic disorders. Certain populations, like French Canadians and Ashkenazi Jews, have higher rates.

Inheritance Patterns

FH is present from birth, with a 50% chance of inheritance if one parent has it. If both parents have FH, there’s a 25% likelihood of inheriting the more severe form, known as Homozygous FH.

Heightened Risk of Heart Disease

Individuals with FH face a significantly increased risk of heart disease, with men often experiencing heart attacks between the ages of 40-50 and women at age 50-60. Early intervention is crucial to mitigate this risk.

Treatment Options

While lifestyle changes like diet and exercise are important, they’re often insufficient to manage hereditary high cholesterol. Statin medications are the cornerstone of treatment, with additional options like PCSK9 inhibitors available for more aggressive cases.

In conclusion

Despite its hereditary nature, high cholesterol is manageable with a proactive approach, including medication, reaching a healthy body weight, lifestyle modifications, and regular monitoring. With proper care, individuals with FH can significantly reduce their risk of heart-related complications.

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911. 


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