We're often under the impression that certain conditions, like high cholesterol, can only occur in older adults. In fact, the US Center for Disease Control and Prevention (CDC) suggests that a person's risk for high cholesterol goes up with age, as our bodies cannot clear cholesterol from the blood as well as they could when we were younger.
But did you know that some people can inherit high cholesterol? They're born with high Low-Density Lipoprotein (LDL) cholesterol, which is said to be harmful for your heart. Speaking with the OnlyMyHealth team, Dr Prashant Pawar, Consultant-Cardiology, Fortis Hiranandani Hospital, Vashi, sheds light on the condition called Familial Hypercholesterolemia (FH).
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What Is Familial Hypercholesterolemia?
FH is a genetic disorder that leads to high LDL cholesterol levels and generally begins in childhood. While most people have cholesterol levels that rise with age, people with FH are born with it, and their cholesterol levels get higher over time.
The CDC suggests that the condition affects about one in 250 people and increases the likelihood of having coronary heart disease at a younger age.
Dr Pawar says, “Although atherosclerosis due to FH manifests primarily in adulthood, it has a precocious inception as early as the first ten years of a person’s life. In most cases, early treatment of risk factors can reverse the atherosclerotic changes in the arterial system. However, there is an urgent need for prompt detection and treatment of children with this condition.”
Causes Of Familial Hypercholesterolemia?
Though single-gene disorders play a crucial role in the aetiology of FH, linkage studies have revealed that most cases of FH are caused by numerous unexceptional genetic variations, according to Dr Pawar.
“An interplay of polygenic variations and environmental factors is one of the leading causes of FH in the general population,” he shares.
Which Age-Group Should Be More Watchful?
As per a 2016 study published in the Archives of Medical Science, FH is more prevalent among women than in men. Researchers also noted that the prevalence was highest in the age group of 45–54 years in men and 55–64 years in women.
Dr Pawar says, “Genetic screening entails identifying the prevalent genes associated with FH in suspected children and their immediate family members.”
According to recent National Institute for Health and Care Excellence (NICE) guidelines, DNA testing is recommended for all patients with FH. Therefore, universal screening is best performed between 9 and 11 years of age, whereas screening at any time after the age of 2 is preferred in candidates for targeted screening, the doctor adds.
Also Read: 5 Genetic Diseases That May Be Inherited In A Woman From Her Mother
Management Tips
“Lifestyle changes, along with therapeutic lifestyle adjustments, form an integral part of FH management,” says Dr Pawar.
These changes encompass:
- Dietary changes
- Regular exercise
- Limitation of alcohol intake
- Strict abstinence from tobacco products
According to recent guidelines, a low-calorie diet with a total fat intake of ≤3% of the total dietary intake, including <8% of saturated fat and <75 mg/1,000 kcal cholesterol, is recommended for these patients, says the doctor, adding that the former guidelines issued by the National Heart, Lung, and Blood Institute (NHLBI) have suggested that treatment with bile acid sequestrants can be given to patients as young as ten years.