‘I’m a Cardiologist, and This Is the #1 Most Important Thing To Do if You Know You’re at Risk for High Cholesterol'

With virtually every health condition, nature and nurture both come into play. It’s important to know what your inherited risk factors are, but it’s also important to know what’s in your control. This is certainly true when it comes to heart health.

High LDL cholesterol (that’s the “bad” kind) can be caused by unhealthy diet and lifestyle habits, but it can also run in your family. If that's the case for you, there's life-saving information cardiologists want you to know, including a tell-tale warning sign to be on the lookout for.

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How Much of High Cholesterol Is In Our Control?

If high cholesterol runs in your family, Dr. Mustali Dohadwala, MD, the medical director and practitioner at cardiology-focused private practice Heartsafe Boston, says that your chance of inheriting high cholesterol can be as high as 50%. Cardiologist Dr. Stephanie Saucier, MD, FAAC, adds to this, saying, “There is an inherited genetic condition known as familial hypercholesterolemia where very high LDL cholesterol levels are seen at a young age.” She explains that people with hypercholesterolemia are at very high risk of heart attack or stroke and often have to take multiple cholesterol-lowering medications (on top of diet and exercise) to reduce LDL cholesterol to a desirable level.

Dr. Saucier explains that most of the cholesterol in our bodies is made by our liver under genetic control, not the food we eat. This means that when someone has inherited high cholesterol, a low-fat, low-cholesterol diet may not be enough to slow down the development of plaque in their arteries.

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While this can be disheartening (no pun intended) to hear, it doesn’t mean that having a family history of high cholesterol means you are doomed to experience poor heart health yourself. Dr. Saucier says it just means that it’s even more crucial to be proactive about prioritizing your heart health. “Many cardiovascular deaths happen without warning, but they are preventable. Up to 80% of heart disease can be prevented through modifying risk factors. It is critical for everyone, especially those who have had a recent heart event or are at risk, to make managing heart health a top priority,” she says.

The #1 Most Important Thing To Do if You Know You're at Risk for High Cholesterol

If you have a family history of high cholesterol, part of being proactive about your own heart health means knowing what your cholesterol numbers are. “The only way to know if you have high LDL cholesterol is to have a blood test,” says Dr. Erica Spatz, MD, MHS, an Associate Professor of Cardiology and Associate Professor of Epidemiology at Yale School of Medicine. Dr. Saucier recommends having your healthcare provider check your cholesterol numbers at your yearly checkups. It’s never too early to know your numbers. Dr. Dohadwala recommends anyone 20 and older who has a family history of high cholesterol get their cholesterol levels checked annually by their healthcare provider.

There is also a physical sign of high cholesterol Dr. Spatz says people with familial hypercholesterolemia can experience that many people aren’t aware of. She says that very high cholesterol can deposit on the skin, eyes and earlobes. Other places Dr. Spatz says that skin deposits of cholesterol can appear on include the elbows, wrists and knees. “Cholesterol can also build up on the Achilles tendon, causing tightness and pain. The eyes can develop a ring called corneal senilis,” she says.

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Dr. Dohadwala says that high cholesterol can cause other changes to the skin including psoriasis and skin granulomas (which look like bumps of lumps on the skin). If you are experiencing any of these symptoms, it’s important to see your healthcare provider ASAP so you can get your cholesterol under control.

While these physical symptoms of high cholesterol can occur, Dr. Saucier emphasizes that there are often no warning signs at all before a major cardiac event such as a heart attack. This is why it’s important to know your cholesterol numbers even if you don’t have any noticeable physical signs of high cholesterol.

What’s encouraging is that high cholesterol is controllable. All three cardiologists emphasize that medications, primarily statins, can play a major role in helping people with a family history of high cholesterol when paired with healthy diet and lifestyle habits. What's important is to take action. You are more than your genetics!

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Sources

• Dr. Mustali Dohadwala, MD, medical director and practitioner at cardiology-focused private practice Heartsafe Boston

• Dr. Erica Spatz, MD, MHS, Associate Professor of Cardiology and Associate Professor of Epidemiology at Yale School of Medicine

• Dr. Stephanie Saucier, MD, FAAC, cardiologist and Director of the Women's Heart and Wellness Program at Hartford Healthcare