Most people associate high cholesterol with an unhealthy diet, lack of exercise, or aging — something that builds up slowly over time. But for some, elevated cholesterol isn’t the result of lifestyle at all. Instead, it’s inherited through a genetic condition known as familial hypercholesterolemia (FH).

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🧬 What Is Familial Hypercholesterolemia?

FH is caused by a genetic mutation that leads to lifelong high LDL (“bad”) cholesterol levels, regardless of diet or activity. According to the U.S. Centers for Disease Control and Prevention (CDC), about 1 in 250 people has FH. Yet experts estimate that 70–90 percent remain undiagnosed, leaving them at risk for serious heart problems.

Without proper management, FH greatly increases the risk of early heart attacks and strokes. Detecting it early can be lifesaving.

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🩺 Why Cholesterol Matters

Cholesterol itself isn’t harmful — in fact, it’s essential. Every cell in the body needs cholesterol to build membranes and produce hormones. But problems arise when LDL cholesterol builds up in the artery walls.

Excess LDL particles trigger inflammation, much like a splinter under the skin. Over time, this can damage artery linings and cause dangerous blood clots — the underlying process behind most heart attacks and strokes.

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⚠️ Signs and Symptoms

Most people with high cholesterol feel no symptoms until serious complications occur. FH is especially insidious because cholesterol levels are high from birth.

In rare cases, very high cholesterol may cause:

• Fatty deposits in tendons (xanthomas)

• Yellowish patches on the skin

• A white ring around the cornea of the eye

But for most, routine blood tests are the only way to detect it.

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🔎 Who Should Be Tested?

• Children: Pediatric guidelines recommend cholesterol screening between ages 9–11 if a parent has FH. Some children may be tested earlier.

• Adults: There’s no age “too early” for testing. Anyone with a family history of heart disease, stroke, or high cholesterol should ask for screening.

It’s also important to test for lipoprotein(a), another inherited cholesterol particle often elevated in people with FH, which further increases cardiovascular risk.

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🥗 Living With Inherited High Cholesterol

Lifestyle changes alone won’t normalize cholesterol in FH — but they still matter. According to cardiologists, healthy habits can cut cardiac risk by up to 80 percent, even when LDL remains high.

Recommendations include:

• Eating fruits, vegetables, whole grains, lean protein, and nuts

• Limiting added sugars, sodium, red meat, and processed foods

• Exercising at least 150 minutes of moderate activity per week (walking, cycling, swimming)

• Avoiding smoking entirely

Most people with FH will also need cholesterol-lowering medications, such as statins or newer therapies, to reduce LDL and protect the heart.

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✅ A Winnable Battle

A diagnosis of familial hypercholesterolemia may sound daunting, but experts emphasize that it’s treatable and manageable. With the right combination of medical care, lifestyle adjustments, and early detection, people with FH can live long, healthy lives.

As cardiologist Dr. Ashish Sarraju explains:

“In most cases, I consider high cholesterol treatable and a winnable battle.”

The key is awareness — recognizing that if heart disease runs in your family, testing early could make all the difference.