Familial hypercholesterolemia (FH) is a type of high cholesterol. It leads to higher levels of bad cholesterol (LDL) in the blood.
People with FH have a higher risk of heart disease.
FH is caused by a faulty gene that is passed from parents to children. It can come from one or both parents. FH can be severe if both parents have the gene.
The faulty gene makes it hard for the liver to remove LDL from the blood.
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The parent will not always pass the faulty gene to their child. However, if one parent has the gene defect, it raises the child's risk of FH. If both parents have the gene defect, the child's risk of FH is even higher.
FH itself does not cause symptoms. However, high levels of LDL can lead to:
FH raises the risk of heart and blood vessel disease at a young age. This can lead to:
A physical exam and blood tests will be done. To make a diagnosis, the doctor will look for:
Other tests may be done to rule out other conditions.
FH will need lifelong treatment. The goal of treatment is to:
Treatment options include:
To help lower cholesterol levels, the doctor may advise:
Diet and exercise alone may not be enough. Medicines may be given to lower LDL cholesterol. Options may be:
Severe forms of FH may need:
FH cannot be prevented.
National Heart, Lung, and Blood Institute
NORD—National Organization for Rare Disorders
Dietitians of Canada
Heart and Stroke Foundation of Canada
Familial hypercholesterolemia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/familial-hypercholesterolemia. Accessed January 20, 2021.
Familial hypercholesterolemia. National Organization of Rare Disorders website. Available at: https://rarediseases.org/rare-diseases/familial-hypercholesterolemia. Accessed January 20, 2021.
Familial hypercholesterolemia. Genetics Home Reference——US National Library of Medicine website. Available at: https://medlineplus.gov/genetics/condition/familial-hypercholesterolemia. Accessed January 20, 2021.
Soran H, Adam S. Hypercholesterolaemia – practical information for non-specialists. Arch Med Sci. 2018 Jan; 14(1): 1–21.
Last reviewed February 2020 by EBSCO Medical Review Board Marcin Chwistek, MD Last Updated: 1/19/2021