Understanding High Cholesterol & Familial Hyperlipidemias
What is High Cholesterol?
Cholesterol is a fatty substance in your blood. Too much “bad” cholesterol (LDL) or not enough “good” cholesterol (HDL) can cause plaque buildup in arteries (atherosclerosis), increasing your risk of:
Heart attack
Stroke
Peripheral artery disease
Types of Cholesterol
| Type | What It Does |
|---|---|
| LDL (“bad”) | Builds up in arteries, forms plaque |
| HDL (“good”) | Helps remove LDL from arteries |
| Triglycerides | Another fat; high levels raise risk |
Healthy Levels (AHA Guidelines)
| Lipid | Optimal |
|---|---|
| LDL | < 100 mg/dL (lower if high risk) |
| HDL | ≥ 40 (men), ≥ 50 (women) |
| Triglycerides | < 150 |
| Total Cholesterol | < 200 |
*Goals may differ if you already have heart disease, diabetes, or very high risk.
What Are Familial Hyperlipidemias?
These are genetic conditions where cholesterol levels are abnormally high from birth, regardless of diet or lifestyle.
Familial Hypercholesterolemia (FH):
- Very high LDL (>190 mg/dL in adults, >160 mg/dL in children)
- Often runs in families
- Causes early heart disease if untreated
Other Rare Forms:
- Familial combined hyperlipidemia
- Familial hypertriglyceridemia
Why Does It Matter?
High cholesterol and familial hyperlipidemias significantly increase the risk of heart attack or stroke, sometimes decades earlier than average. Early detection and treatment are critical.
What Can You Do?
- Get your cholesterol checked at least every 4–6 years (more often if high risk)
- Eat a heart-healthy diet (more fiber, less saturated & trans fat)
- Be active & maintain healthy weight
- Don’t smoke
- Take prescribed medications (statins, PCSK9 inhibitors, etc.)
- If you have FH, family members should also get tested
When to Get Help?
If you or a family member has very high LDL cholesterol above 190 or a history of early heart disease, high cholesterol and familial hyperlipidemias may be the cause. Schedule an appointment with Insight Heart Health for genetic testing and personalized management.