Inherited High Cholesterol: What is Familial Combined Hyperlipidaemia

Question: A pregnant lady has normal cholesterol, but her own mother is suffering from FH. How can she check if her baby has inherited FH? What is FCH? Should one even check the triglyceride levels? Is a person doomed to a heart attack or stroke if he has inherited high levels of cholesterol? When is drug treatment for cholesterol recommended?

Familial Combined Hyperlipidaemia

Babies who suffer from inherited familial hypercholesterolemia (FH) will have two times higher levels of LDL in the blood from their umbilical cord as compared to levels in the normal babies.

When the baby is one year old, its blood sample can be taken for testing. If the results are positive then it will help the mother to make an early start in controlling cholesterol so she can check the development of advanced atherosclerosis.

It is now very clear that high cholesterol levels can be inherited. People who develop heart disease before the age of fifty five sometimes can also inherit high triglyceride levels which progresses to a condition called familial combined hyperlipidaemia (FCH). If either of the parents or sibling has FCH then half of the first degree relative can also develop FCH.

So if one has low HDL, LDL is too high and Triglyceride level is higher than 250 – 500mg/dL or above one has probably inherited the FCH gene. And it may have then passed on to the sufferers offspring. So those children’s triglyceride level should also be checked.

An individual may not necessarily suffer from a heart attack or stroke if has inherited high cholesterol. The individual is more likely to have premature heart disease (as compared to someone without a family history of FH). But he can also control his cholesterol and reduce the chances of early heart attack by adhering to a low-fat, low cholesterol diet.

Such diets help to increase the number of LDL receptors, which in turn leads to a decrease in LDL in the blood. But one will have to monitor their cholesterol lifelong. Excess weight should be shed off and thereby one should not exceed more than twenty pounds of ideal body weight; smoking should be avoided and Blood Pressure should be controlled.

Drug Treatment for Cholesterol

A drug treatment is advised depending on the cholesterol levels, age and other risk factors. If a fifteen year old has cholesterol level of 600mg/dL it is best to use medication and get down the cholesterol levels as quickly as possible. But if it is 280mg/dL it is better to start with dietary measures and wait until the age of twenty or twenty five to start drugs. If adults have cholesterol levels around 500mg/dL dietary methods can be started. If these fail to work after certain time, drugs such as bile acid binding resins can be used. They will lower total cholesterol by removal of LDL cholesterol.