Familial hypercholesterolemia

Overview

What is familial hypercholesterolemia

Familial hypercholesterolemia (FH) is a rare genetic disorder that involves extremely high amounts of cholesterol in the blood, especially low-density lipoprotein (LDL). Because high LDL is one of many risk factors associated with heart disease, LDL is often called “bad” cholesterol. Patients with FH are unable to effectively remove the bad cholesterol from the blood which increases their risk of stroke and heart disease. Familial Hypercholesterolemia can be caused by inheriting one or more different defects from each parent (heterozygous - HeFH), or two copies of the same defect, one from each parents (homozygous - HoFH). Homozygous patients and patients with multiple defects tend to experience more serious complications compared to patients with a single defect. Without treatment, risk of death from heart disease is nearly double that of same-aged people. In those with HoFH, heart disease can occur in early adulthood (20s and 30s). Traditional lifestyle recommendations (heart-healthy diet, not smoking, exercise, etc) and typical cholesterol-lowering medications (such as statins) are not enough to control cholesterol levels in FH patients. In some cases, special medications for HoFH are necessary. Additionally, a procedure called apheresis may be done to periodically filter cholesterol out of the blood (similar to dialysis).

How common is familial hypercholesterolemia

Heterozygous FH occurs in approximately 1 in 300 to 500 people. Homozygous FH is very rare, affecting approximately 1 in 1 million Americans.1


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  • 1Goldberg, Anne C., et al. "Familial hypercholesterolemia: screening, diagnosis and management of pediatric and adult patients: clinical guidance from the National Lipid Association Expert Panel on Familial Hypercholesterolemia." Journal of clinical lipidology 5.3 (2011): S1-S8.