High cholesterol isn’t just a concern for grown-ups. About one in 250 kids has a genetic condition called familial hypercholesterolemia, which causes cholesterol to build up in their arteries from birth. These children are at risk for developing early heart disease, even if they lead a healthy lifestyle. When it comes to combatting it, knowledge is key.
Cardiologists Dr. Brad McQuilkin and Dr. Chris Snyder answer 6 questions about identifying and addressing inherited high cholesterol in children
What is cholesterol, and is it always bad?
Cholesterol is a waxy, fat-like substance found in cells throughout the body. We need cholesterol to produce vitamins and hormones that keep our bodies healthy. Too much cholesterol, though, can be problematic.
Cholesterol attaches to other molecules and circulates in the blood. When there’s too much, it can form deposits in the arteries, narrowing or blocking them and making it difficult for blood to flow. This buildup is called plaque and increases the risk of heart disease, heart attack and stroke.
What causes high cholesterol?
The liver makes all the cholesterol our cells need to function properly. We get extra cholesterol from foods, specifically animal products like dairy, eggs and meat. Usually, the body can break down and remove the cholesterol we don’t need, but in a condition called familial hypercholesterolemia – or FH – a gene mutation disrupts this process. Instead of being filtered out of the body, cholesterol begins building up in the arteries as soon as a baby is born.
How is FH different from high cholesterol typically seen in adults?
FH is an inherited condition caused by receiving a mutated gene from a parent. People with FH are born with high cholesterol. Even if they lead healthy lifestyles, they’re at risk for developing early heart disease.
Other forms of hypercholesterolemia, or high cholesterol, develop over time, often from lifestyle choices, such has dietary and exercise habits. This type of high cholesterol usually develops in adulthood.
How common is FH?
About one in 250 people has heterozygous FH, which means they inherited an FH gene from one parent. Millions of people are living with this condition, but only about 30 percent know they have it. In rare cases, a child will inherit an FH gene from both parents, resulting in homozygous FH. This impacts about one in 300,000 people and is more serious. It can cause heart attacks in the teen years or younger and should be treated right away.
How would I know if my child has FH?
Tell your family’s pediatrician if a close relative (parent, grandparent, aunt or uncle) has high cholesterol, coronary artery disease or experienced a heart attack at an early age (younger than 55 for males or 65 for females). This will help them determine when to start testing your child’s cholesterol. When there’s a family history of heart conditions, cholesterol screenings begin as young as 2 years old. Otherwise, the American Academy of Pediatrics recommends beginning screenings between 9 and 11 years old. Screenings may include a lipid panel blood test to measure cholesterol levels and/or a DNA test to look for the genes that cause FH.
What can be done to help a child with FH?
The good news is that when FH is identified and treated, the associated risks reduce tremendously. Your child’s pediatrician will likely refer you to a pediatric cardiologist, who may recommend medications to reduce the amount of cholesterol made by the liver and/or help the body remove cholesterol from the bloodstream. Another treatment option is lipoprotein apheresis, which is a weekly procedure where a machine filters cholesterol from the blood.
While FH isn’t the result of unhealthy food or exercise habits, eating a healthy diet and staying active are essential for overall health.