What is the difference between high cholesterol and familial hypercholesterolemia?

Most people know that high cholesterol can cause narrowing or blocked arteries, increasing your risk of life-threatening heart attacks and strokes.

What many people might not realise is that some people develop high cholesterol as a result of a genetic disorder, which is known as Familial Hypercholesterolemia (FH), and are much more likely to suffer from aggressive, early-onset heart disease that can lead to heart attacks or death.

Are you affected by FH all your life?

Yes, FH is a lifelong journey. It is not a temporary condition. FH is not curable but it is treatable. When you have FH, the most important step is to take is following the treatment suggested by your doctor.

I have been diagnosed with FH but I don’t like the idea of taking medication. Can I lower my cholesterol through diet?

FH causes excessively high LDL-cholesterol levels. This is dangerous as it leads to cholesterol getting built up in your blood vessels, leading to atherosclerosis, heart attacks, and even death. Diet alone is almost never enough to manage your condition.

In all cases, FH requires aggressive treatment. Your doctor will be able to discuss the best treatment plan for you.

What level of cholesterol should I aim for?

Your doctor will discuss the best treatment plan for you and agree target levels for your cholesterol. For most adults with FH, the aim is to cut your LDL cholesterol level by half.

The average total blood cholesterol level of adults living in Ireland is 5.1mmol/l. Adults who have FH, and are already diagnosed with coronary heart disease or who have had a stroke or other forms of arterial disease, should try to reduce total cholesterol to 4mmol/l or below, and reduce LDL cholesterol to 2mmol/l or below.

Your doctor will arrange for you to have blood tests each time you go to the clinic. The results of these tests will show how well your cholesterol is being controlled and help your doctor decide if any changes need to be made to your medicines. Your doctor will probably see you more often when you are first diagnosed with FH – perhaps once every two to three months. Once your treatment is stable, your visits will be less frequent – perhaps just once a year.

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