Is Your High Cholesterol Due to Nature or Nurture?

Forty percent of U.S. adults have high cholesterol, and many claim their numbers are a matter of genetics. While it’s true that high cholesterol can run in families, it’s important to understand the difference between genetically high cholesterol that’s caused by a gene mutation and cholesterol that’s high among many family members who may share unhealthy lifestyle factors.

About 1 in 250 (0.4%) people in the world have familial hypercholesterolemia (FH), or what’s commonly known as genetic high cholesterol. FH is caused by gene mutations in one of three genes: LDLR, Apolipoprotein B or PCSK9. While anyone can have it, it’s more frequently found in people of French Canadian, Ashkenazi Jewish, Lebanese or Afrikaner (a South African ethnic group) descent. Left untreated, 50% of men by age 50 with FH and 30% of women by age 60 will have a heart attack. There are several treatment options for people with FH, but nearly 80% of people with FH don’t know they have it. Many are young, healthy and have no other risk factors for heart disease, so they’ve never tested their levels. Often, there are no symptoms of FH, but some patients may notice:

1. Family members who had heart attacks or strokes before the age of 50
2. Fatty deposits under your skin – often seen around eyes, hands, knees and the Achilles tendon
3. Yellowish areas around eyes
4. Chest pain
5. Sores on the toes that don’t heal

If you think you or a family member may have FH, talk with your physician to set up a blood test. Even children and young adults with FH can experience heart-related events if untreated.

Having family members with high cholesterol doesn’t always mean you have FH. In fact, most people with high cholesterol don’t have FH. While your individual genetic makeup does have an impact on how your body processes cholesterol, inactivity, obesity, smoking, drinking alcohol, and an unhealthy diet all increase your risk of high cholesterol and heart disease as you age. The good news is that if you don’t have FH, it’s more likely that lifestyle modifications alone can help you reduce your risk of heart disease. Some lifestyle changes that can help you lower your risk include:

1. A low-salt diet that emphasizes fruits, vegetables and whole grains
2. Limiting the amount of animal fats in your diet
3. Maintaining a healthy weight
4. Not smoking
5. Exercising on most days of the week for at least 30 minutes
6. Drinking alcohol in moderation, if at all
7. Managing stress

Even with lifestyle modifications, some people still need to take medications to lower their cholesterol, especially as they age. And whether your issues stem from genetics or other factors, it’s important to get an annual physical and monitor your cholesterol and other health indicators.

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Benjamin Levron, MD
Family Medicine 
Baton Rouge General Physicians - Bluebonnet Family Clinic
(225) 333-3590