Preventing Heart Disease: Is High Cholesterol Genetic?
The Role of Cholesterol in Heart Health: Facts You Need to Know
Genetics can play a significant role in determining a person’s cholesterol levels.
Family members inherit familial hypercholesterolemia, a genetic disorder that leads to high levels of cholesterol in the blood.
If you have this genetic disorder, it means you have a mutated gene that does not regulate cholesterol metabolism properly.
This mutation results in the liver being less able to remove low-density lipoprotein cholesterol -- commonly called LDL -- from the blood, leading to elevated levels of bad cholesterol.
Genetics is not the only factor that can lead to high cholesterol, but family history is a factor everyone should consider.
What is cholesterol buildup?
Cholesterol makes hormones, vitamin D, and bile acids. These are in foods such as meat, poultry, fish, and dairy products. Cholesterol build-up occurs when a fatty substance builds up inside the cells of the artery.
Too much cholesterol in the bloodstream can build up inside the arteries, causing plaque. Plaque can cause the arteries to narrow, leading to a blockage of blood flow. This narrowing and blocking of blood flow can cause a rupture leading to a heart attack or stroke.
A heart attack and stroke can cause cardiovascular disease or risk heart disease.
What are the types of cholesterol?
There are two main types of cholesterol.
Low-density lipoprotein (LDL): This is bad cholesterol because LDL builds up inside the walls of the arteries causing plaque. The goal is to have a low level of LDL.
High-density lipoprotein (HDL): This is good cholesterol because it can remove LDL from inside the arteries. HDL can be produced by eating a healthy diet, getting regular exercise, or medication.
"I noticed that when I would walk, I had to stop to catch my breath, which was not normal."
Kate Young retired in 2020. She rested for a few months and took it easy. She started to go for walks. However, when she did, she could not catch her breath. This was not normal.
Working in healthcare for 40 years, she knew she needed to see a doctor. Kate went to her primary care provider, who recommended a cardiologist because she had high cholesterol. The cardiologist recommended a procedure called cardiac catheterization, which can measure blockages and rhythms of the heart.
Family History of Genetic High Cholesterol
Knowing your family medical history is incredibly important for understanding your risk of cardiac disease. It offers insights into the genetic factors that can contribute to heart issues. If close relatives like parents, siblings, or grandparents have had cardiac problems, it increases your risk of similar issues.
Your family's medical history also helps healthcare professionals evaluate your risk and provide personalized preventive measures. Knowing your family's cardiac history allows you to work with your doctors to make informed choices about your lifestyle, screenings, and medical interventions. This proactive approach can significantly reduce the chances of developing serious heart conditions and promote long-term cardiovascular health.
"I think that a lot of people really don't understand how much your medical history can play in a lot of different illnesses, but especially cardiac disease."
Kate's father died at the age of 54 from a sudden heart attack. Two of her brothers also died of a heart attack. With a strong family history, and as a nurse, Kate knew that she needed to watch for signs of heart disease. Kate started seeing a cardiologist at the age of 40 to conduct stress tests. Also known as an exercise stress test, the stress test is a medical examination that assesses the heart during physical activity.
She had a stress test done about three years prior to getting a stint, which was negative.
But when she retired, she didn't pay attention to her blood pressure or her pre-diabetic condition caused by obesity. "I think a lot of those things were covered in depth in my rehab program, which just makes you more self aware."
"It really gave me the tools to make the changes that I need to live a healthy life."
Cholesterol Build Up
Pictured above is an illustration that shows the progression of narrowing or blockage of the coronary arteries. This condition is caused by build-up of cholesterol and fats inside the arteries.
Kate's Blockage
The cardiologist found a 70% blockage of Kate's LAD, which is the left anterior descending artery of her heart. They put in a stent, which is a tiny tube that can open arteries.
After the procedure, Kate knew she needed to be more active, but she felt afraid to exercise on her own.
The CHRISTUS team placed Kate in a comprehensive cardiac rehab program. The nursing team, exercise physiologist, and dietitians began educating Kate on heart disease. She participated in a supervised exercise program where clinicians monitored her heart as she exercised. Dieticians provided actual cooking demonstrations and gave Kate a booklet with recipes and dietary training.
"It's an extremely comprehensive program, you learn what risk factors you have, you learn how to modify those risk factors. You learn how to exercise, you learn about nutrition, things that even being a nurse that I really didn't pay attention to." - Kate
What causes high cholesterol?
- Eating food that is high in saturated fat: Red meat, butter, cakes, biscuits, sausages, bacon, cheese, and ice cream.
- Eating food that is high in trans fats: Cookies, fried foods, biscuits, frozen pizza, and French fries.
- Not getting enough exercise: Experts recommend that adults should have at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity each week.
- Being overweight: Being overweight increases your chances of having too much unhealthy cholesterol in your blood. It can increase the chances of having heart problems. Losing weight can help you have healthy cholesterol levels because it can help reduce the amount of fat in your body.
- Smoking: Smoking damages the lining of arteries which can cause a buildup of plaque. This can cause high cholesterol levels leading to an increase in heart disease. The chemicals in the cigarette can also damage a liver’s ability to process cholesterol.
- Family history: A family history of high cholesterol is a contributor to cholesterol buildup.
- Alcohol: Drinking too much alcohol can contribute to heavy cholesterol and triglycerides buildup in your liver. The liver cannot remove cholesterol from your blood, and it will cause cholesterol levels to rise.
Prevention and Treatment
How to prevent cholesterol buildup
Having healthy cholesterol is important in maintaining a healthy lifestyle. High cholesterol can lead to cholesterol build-up in the arteries causing poor heart health and several other health complications.
Cardiovascular diseases such as heart attacks and stroke are one of the leading causes of death worldwide.
There are many ways to maintain healthy cholesterol, and below is more information about how to prevent cholesterol build-up and how cholesterol build-up happens.
What are the symptoms of cholesterol buildup?
Symptoms can be hard to detect. It’s important to get your cholesterol checked regularly by a doctor. Due to symptoms being hard to detect, a heart attack or stroke can occur suddenly due to LDL cholesterol buildup caused by heavy plaque buildup in the arteries.
A person can suffer physical issues like chest pain, shortness of breath, nausea, pain in the neck, jaw, upper abdomen, or back, and fatigue from doing minimal physical activity.
If these symptoms occur, contact a doctor to get checked immediately because these signs can cause a heart attack or stroke.
Cholesterol buildup over time can cause heart disease, stroke, and peripheral artery disease. These health conditions can lead to disability and possible death.
How can you tell if your cholesterol is too high?
A blood test is the only way to receive information about your cholesterol levels. A doctor can organize a blood test appointment called a lipid panel and the results from the blood test can measure how high a person’s cholesterol levels are. A blood test can also help determine the amount of plaque in your arteries that can cause narrow or blocked arteries in your body.
Having healthy cholesterol is important in maintaining a healthy lifestyle. High cholesterol can lead to cholesterol build-up in the arteries causing poor heart health and several other health complications.
Cardiovascular diseases such as heart attacks and stroke are one of the leading causes of death worldwide.
There are many ways to maintain healthy cholesterol, and below is more information about how to prevent cholesterol build-up and how cholesterol build-up happens.
A person can suffer physical issues like chest pain, shortness of breath, nausea, pain in the neck, jaw, upper abdomen, or back, and fatigue from doing minimal physical activity.
Cholesterol buildup over time can cause heart disease, stroke, and peripheral artery disease. These health conditions can lead to disability and possible death.
A blood test is the only way to receive information about your cholesterol levels. A doctor can organize a blood test appointment called a lipid panel and the results from the blood test can measure how high a person's cholesterol levels are. A blood test can also help determine the amount of plaque in your arteries that can cause narrow or blocked arteries in your body.
Consult your doctor to receive personalized information about how to have healthy cholesterol.
Eating foods that are low in saturated fats and trans fats: Fruits, vegetables, whole grains, beans, oily fish with omega-3 fatty acids (salmon, mackerel, herring, walnuts, and flaxseeds)
- Eating foods that are high in soluble fiber: Pasta, almonds, trail mix, granola bars, carrots, pears, oatmeal, kidney beans, brussels sprouts, apples, and pears.
- Regular exercise
- Start with 10 minutes of exercise and build your way to 30 minutes of moderate-intensity aerobic activity (e.g. walking).
- Medication
- Statins: Can lower LDL and increase HDL causing a reduction in heart attacks and stroke.
- Fibrates: These can come in gemfibrozil and fenofibrate and can lower LDL and increase HDL.
- Niacin: In large doses, it can improve HDL and LDL but does have more side effects compared to statins or fibrates.
- Resins: Low doses or resins can cause reductions in LDL.
- Limiting alcohol intake
- Heavy drinking can cause cholesterol and triglyceride levels to rise to unhealthy levels. Cutting back on heavy alcohol intake can improve your cholesterol levels to healthy.
- Quit smoking
- Quitting smoking will lower the risk of developing heart disease and damage to the blood vessels. Smoking can cause arteries to harden.
- Smoking can increase unhealthy LDL cholesterol and decrease healthy HDL cholesterol. Smoking can also cause unnecessary plaque to build up in your arteries causing them to narrow.
Going to a primary care provider is the first step in treating high cholesterol levels. Your doctor can work with you to create a plan that best fits your lifestyle and health needs.
A primary care provider will listen and learn about your personal concerns and give guidance on best practices for managing your chronic condition.
Here are some ways a primary care doctor may help treat high cholesterol.
A primary care physician can refer you to a specialist if further treatment is needed for your high cholesterol. Depending on your case, the type of specialist that your doctor may recommend could be a cardiologist or an endocrinologist.
When meeting with the specialist, they will likely assess your medical and laboratory results to determine the best course of action.
This may include:
- Lifestyle changes
- Medications
- Other therapies to help reduce your risk of heart disease and stroke associated with high cholesterol levels
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