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How might my genes affect my cholesterol level?

You may have inherited a trait from your parents that causes high cholesterol. For instance, your liver may produce too much LDL cholesterol or too little HDL cholesterol. Or, you may have faulty LDL receptors on your liver cells. Normally, your body removes LDL mostly by absorbing it from your blood into your liver using these receptors. If your receptors don't work well, more LDL will stay in your blood. And that means your LDL level may be higher than normal.

Familial hypercholesterolemia. There are even some people who have no receptor sites on their liver cells to absorb LDL from the blood. They have a form of inherited high cholesterol called familial hypercholesterolemia, or FH for short. People who have FH have high cholesterol from birth. Their LDL levels may be two to three times higher than normal. There are two forms of FH. About 1 in 500 people has the more common form, and about 1 in 1 million has the less common form.

What to know. If you have FH, you are at greater risk for developing atherosclerosis and other blood vessel diseases. The risk of dying from a heart attack before age 40 is much higher in people who have FH than in those who don't have the condition. Many people with FH experience no symptoms before suddenly having a fatal heart attack. If you have this condition and you have very high levels of blood cholesterol, you are at extremely high risk for heart attack. It's essential that you receive treatment.

To treat FH, your doctor will talk with you about eating a diet low in saturated fat and taking medicine.