You Experience Leg Pain While Exercising
If you experience a burning pain or feel like your legs are tired or heavy it may indicate poor blood flow to your legs, which could be related to high cholesterol. Pain may impact one or both legs, as well as any part of the leg from the calf to your buttocks. Most of the time the pain subsides with rest but then reoccurs when you do the same level of activity again, such as walking two blocks.
What Can Raise My Risk Of High Cholesterol
A variety of things can raise your risk for high cholesterol:
- Age. Your cholesterol levels tend to rise as you get older. Even though it is less common, younger people, including children and teens, can also have high cholesterol.
- Heredity. High blood cholesterol can run in families.
- Weight. Being overweight or having obesity raises your cholesterol level.
- Race. Certain races may have an increased risk of high cholesterol. For example, African Americans typically have higher HDL and LDL cholesterol levels than whites.
How To Lower Cholesterol With Fh
Lifestyle changes alone usually aren’t enough to lower cholesterol for people with FH, which differentiates it from those who have developed high cholesterol without the genetic condition.
Those with FH typically need medication to lower cholesterol, in addition to adopting recommended lifestyle changes like eating a low-fat diet, quitting smoking, and regular exercise.
Statins are usually prescribed to lower cholesterol for those with heterozygous FH, as they have been associated with a reduced risk of heart disease and stroke. People with homozygous FH may need LDL apheresis a dialysis-like procedure that removes cholesterol from the blood and has been found to lower LDL cholesterol by about 70% to 83%.
Early diagnosis and treatment for FH patients is important. Research has found that childhood intervention can reduce the risk of mortality and coronary artery disease. And when treated, the risk of heart disease and stroke in people with FH can even drop to levels consistent with the general population.
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Familial Hypercholesterolemia And Other Forms Of High Cholesterol
Cholesterol is a housekeeper in your body. It’s one of many lipids, or fats, your body needs to repair cells and tissues and make things like hormones. You also need cholesterol for energy.
Cholesterol can be confusing. One form of it helps your body, and the other form can be harmful. If high cholesterol runs in your family, you should get a cholesterol test as early in life as possible, as high cholesterol can lead to many cardiovascular diseases.
“We need some cholesterol, there’s no question about it, but not too much,” says Northwestern Medicine Preventive Cardiologist Donald M. Lloyd-Jones, MD. “It’s when we’re exposed to excess levels of bad cholesterol that we get into trouble.”
We need cholesterol, there’s no question about it, but not too much.
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| This information has been updated to reflect recent scientific research as of June 2021. |
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Current Research On High Cholesterol
The study of the genetics of high cholesterol will focus on familial hypercholesterolemia genetics and its effect on patients from an early age. This 2017 review collected information from many reports to obtain how common heterozygous familial hypercholesterolemia is and how it confers risk for premature cardiovascular disease .
Last year, the American Heart Association in their journal Circulation about the prevalence of familial hypercholesterolemia and patients with atherosclerotic cardiovascular disease.
For treatment, the FDA recently approved an add-on therapy called Evekeeza to treat patients with homozygous familial hypercholesterolemia . This injection can be administered to patients aged 12 and older.
Besides drugs and medication, researchers are also looking to apply nanotechnology to diagnose and treat high cholesterol. Some approaches, reviewed in this 2017 study, have proven safe and effective, while others are still in development.
Treatment For Familial Hypercholesterolaemia
There is no cure for familial hypercholesterolaemia. Treatment aims to reduce the persons risk of coronary artery disease and heart attack, and may include:
- Dietary changes recommended dietary changes include reduced intake of saturated fats and cholesterol-rich foods, and increased intake of fibre. Modifying the diet is usually the first line of treatment. After three months, test results will show whether more aggressive treatment is needed.
- Plant sterols and stanols these substances are structurally similar to cholesterol, but arent absorbed by the cells. Studies show that increasing the intake of plant sterols and stanols can substantially reduce blood cholesterol. Sources include corn, rice, vegetable oils and nuts.
- Exercise regular exercise has been shown to reduce blood cholesterol levels. Any exercise program should be supervised by your doctor.
- Weight loss obesity is a risk factor. Maintaining a healthy weight for your height can reduce your risk of coronary artery disease and heart attack.
- Avoid smoking cigarette smoke encourages cholesterol to stick to artery walls. Quitting can significantly reduce your risk of heart attack.
- Medication very few people with familial hypercholesterolaemia will be able to reduce their cholesterol levels by diet and lifestyle changes alone. Most will need special cholesterol-lowering drugs.
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What Are The Treatments For High Cholesterol In Children And Teens
Lifestyle changes are the main treatment for high cholesterol in children and teens. These changes include
- Being more active. This includes getting regular exercise and spending less time sitting
- Healthy eating. A diet to lower cholesterol includes limiting foods that are high in saturated fat, sugar, and trans fat. It is also important to eat plenty of fresh fruits, vegetables, and whole grains.
- Losing weight, if your child or teen is overweight or has obesity
If everyone in the family makes these changes, it will be easier for your child or teen to stick to them. It is also an opportunity to improve your health, and the health of the rest of your family.
Sometimes these lifestyle changes are not enough to lower your child or teens cholesterol. Your health care provider may consider giving your child or teen cholesterol medicines if he or she
- Is at least 10 years old
- Has an LDL cholesterol level that is higher than 190 mg/dL, even after six months of diet and exercise changes
- Has an LDL cholesterol level that is higher than 160 mg/dL AND is at high risk for heart disease
- Has an inherited type of high cholesterol
How Genetics Impact Your Cholesterol Levels
“Many people inherit genes from their parents that cause them to have too much cholesterol,” says Dr. Sadi Raza, MD, a cardiologist practicing in Dallas. This disorder is known as familial hypercholesterolemia, or FH. “FH is dangerous because it can cause premature atherosclerosis, and thus heart disease and strokes at a younger than expected age,” he explains. Your doctor can order a test that will detect the presence of the disorder.
It is hard to say to what degree genetics matter more than lifestyle, but regardless, you should change your lifestyle to decrease your risk.
“I will say this: If you have a strong genetic predisposition for elevated cholesterol, it is even more important to have good lifestyle habits because the effect is additive and compounds the issue,” Dr. Raza says.
“Genetics can play a strong role in your risk for high cholesterol by increasing the amount produced by the liver and so in those who have high cholesterol but also have a healthy lifestyle, it’s more likely that genes are at play,” says Kelly Jones MS, RD, CSSD, LDN.
While we need cholesterol, high levels of these lipoproteins can mean build up of plaque in the arteries and an increased risk of heart attack. A blood test will measure HDL and LDL levels, where HDL is the “good” kind of cholesterol and LDL is the “bad” kind.
“HDL should be above 40 for men and 50 for women, while it’s desirable for LDL to be below 100, and total cholesterol should be between 125 and 200 mg/dL,” Jones says.
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Can I Pass Fh To My Kids
If you inherited FH from one parent, theres a 50% chance youll pass it on to your children. If both of your parents passed the FH trait to you, your children will definitely have FH. Thats why its crucial to get children with a family history tested at an early age and begin cholesterol-reducing treatment for those with FH.
People with FH are usually not diagnosed until their 30s or 40s or later. Unfortunately, far too few are diagnosed as children. But early treatment can significantly impact a persons lifetime cardiovascular health by lowering their long-term exposure to high cholesterol levels, Martin advises. The treatment keeps their arteries healthier and prevents premature heart attacks and strokes.
Causes Of High Cholesterol
In addition to genetics, high cholesterol arises due to several factors:
- Diet: Certain foods, especially those high in trans and saturated fats , elevate cholesterol levels.
- Level of activity: Those who do not get enough exercise or physical activity are at risk for high cholesterol.
- Weight status: Being overweight of 25 to 29.9) or obese are significant risk factors for high cholesterol.
- Lifestyle factors: Smoking tobacco and consuming alcohol are directly linked with higher levels of cholesterol.
- Medications: Certain medications, including certain steroids, antiviral medications, beta-blockers, immunosuppressants, and diuretics, among others, can cause levels to rise.
- Other diseases: Higher cholesterol can also be caused by other diseases or health conditions, including chronic kidney disease, human immunodeficiency virus , hepatitis C, and pregnancy, among others.
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Can You Lower Cholesterol If Its Genetic
While high cholesterol can be tougher to take on if it’s due to FH, it can be managed. Making lifestyle changes such as adopting a cholesterol-lowering diet and increasing physical activity is the first step in lowering cholesterol.
Since FH cases are often resistant to these approaches, taking cholesterol-lowering drugs, such as statins or bile acid sequestrants, can further manage the condition. In severe cases of HoFH, pharmaceutical therapies may be supplemented with apheresis or liver transplant to normalize levels.
Can Fh Be Inherited
Like many diseases, familial hypercholesterolemia can be passed on to children. However, having the condition does not automatically mean your children will have it.
If one parent has heterozygous FH and the other parent does not, the children will have a 50% chance of having the condition. If both parents have heterozygous FH, the children will have a 75% chance of inheriting the genetic mutation. If one parent has homozygous FH and the other parent does not, the children will have a 100% chance of having the condition since one of the parents is certain to pass down a mutated gene.
Given the high likelihood of children inheriting the genetic mutation that causes FH, it is crucial to have the children undergo genetic testing to find out if they have inherited the gene. The earlier the child receives a medical diagnosis, the sooner they can be treated.
Early detection and treatment of FH can improve ones life outlook. It can also prevent several serious diseases such as coronary artery disease, heart attack, stroke, and kidney disease.
If, in case, you have familial hypercholesterolemia, there are things you can do to reduce your risk of heart disease. For example, exercising regularly can raise your HDL or good cholesterol levels, which protects you against heart disease. It is also important to eat a healthy diet to maintain a healthy weight, which reduces your risk of diabetes and metabolic syndrome.
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Toward Ai In The Clinic
Once the algorithm was trained, the team moved on to the testing phase, initially running it on a set of roughly 70,000 de-identified patient records it had never encountered. From the patients flagged, the team reviewed 100 patient charts, extrapolating that the algorithm had detected patients who had FH with 88 percent accuracy.
Next, the researchers teamed up with the Geisinger Healthcare System to test the algorithm on 466 FH patients and 5,000 non-FH patients. The predictions came back with 85 percent accuracy, and we knew that many of the Geisinger patients had a confirmed FH diagnosis with genetic sequencing, Shah said. So thats how we convinced ourselves that yes, this indeed works.
Now, Knowles and Shah are working on ways to implement the algorithm in doctors offices, something theyre actively pursuing for Stanfords FH clinic.
The work is an example of Stanford Medicines focus on precision health, the goal of which is to anticipate and prevent disease in the healthy and precisely diagnose and treat disease in the ill.
Why Are Detection And Treatment Important If I Dont Have Any Symptoms
Detection and treatment are very important if you have FH because high cholesterol levels at such an early age can lead to early coronary artery disease, stroke, and heart attack. High cholesterol levels in the blood can also lead to kidney disease.
People with heterozygous FH are often not symptomatic until their first heart attack when they are in their 30s. Once a plaque is deposited in the arteries, its very hard to remove the plaque.
Primary prevention before any major heart events occur is better than having to treat the disease complications after there has been damage to your organs.
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When You Should Get Tested
If youre at low risk for high levels of cholesterol, you should start getting lipid panel screenings starting at age 40 for women and 35 for men. You should have your levels tested about every five years.
If you have more risk factors for cardiovascular disease and high cholesterol, you should start getting lipid panel screenings in your 20s, and at more frequent intervals. If the results show you have unhealthy levels of cholesterol or other lipids, your doctor will work with you to create a treatment and monitoring plan.
What Causes Unhealthy Levels Of Cholesterol To Occur In Your Body
There are two main forms of cholesterol. The first, LDL cholesterol, is often called bad cholesterol. Its considered unhealthy to have high levels of LDL cholesterol in your body. The other, HDL cholesterol, is sometimes referred to as good cholesterol. Higher levels of HDL cholesterol can be a sign of good health.
If your doctor tells you that you have high cholesterol, theyre usually referring to either high levels of LDL cholesterol or a high level of total cholesterol. Total cholesterol is also sometimes called serum cholesterol. Its the sum of LDL and HDL cholesterol and 20 percent of your triglycerides. LDL cholesterol and total cholesterol can be used as indicators of your risk of developing cardiovascular disease and other complications.
A variety of risk factors contribute to unhealthy levels of cholesterol, including genetics, lifestyle choices, or a combination of the two.
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Hdl Cholesterol Or Good Cholesterol
HDL cholesterol is sometimes called good cholesterol. It helps return LDL cholesterol to your liver to be removed from your body. This helps prevent cholesterol plaque from building up in your arteries.
When you have healthy levels of HDL cholesterol, it can help lower your risk of blood clots, heart disease, and stroke.
Causes Of Familial Hypercholesterolemia
Familial hypercholesterolemia is a genetic disorder caused by a mutated gene. This mutation disrupts the bodys ability to remove low-density lipoprotein from the blood as it normally would, resulting in the development of high levels of cholesterol.
The condition is autosomal dominant, meaning the gene mutation can be inherited if only one parent is a carrier. In these instances, the condition is known as heterozygous FH. In the rare case where both parents are carriers, a particularly severe variety of familial hypercholesterolemia known as homozygous FH will be passed on.
The condition is differentiated from standard hypercholesterolemia by its hereditary nature. Anyone can develop hypercholesterolemia which is generally caused by unhealthy lifestyle choices whereas only those with a family history of the condition can develop familial hypercholesterolemia. Standard high cholesterol generally develops in older individuals, whereas the genetic variety is present from birth and has a tendency to be more aggressive.
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What Is Genetic High Cholesterol
Clinically referred to as familial hypercholesteremia , genetic high cholesterol is high cholesterol that runs in families. Specifically, this causes elevated levels of LDL cholesterol , which is linked with an increased risk of developing coronary artery disease.
As an autosomal dominant disorder, parents with FH have a 50% chance of passing it to their children. The most common type is heterozygous FH , which is when only one of your parents is carrying the gene variant that causes the condition. When both parents have it, in cases of homozygous FH , two faulty variants are inherited. The latter is the more severe form.
What Causes High Cholesterol
Studies have shown that FH is caused by genetic mutations that affect the body’s ability to effectively remove LDL or bad cholesterol from the bloodstream.
By age 10, children with FH often have aortic lesions and thicker carotid arteries than siblings who didn’t inherit the condition. Over time, the condition can lead to atherosclerosis and narrowing of artery walls.
Plaques can be detected in about a quarter of adolescents with FH. The signs of heart disease can show up decades earlier in people with FH compared to the general population, and their risk for premature heart disease is 22 times greater.
Ideally, LDL cholesterol levels should be kept under 100 mg/dL. But FH causes LDL cholesterol levels to go above 190 mg/dL . About 50% of people with the condition will get a heart attack or stroke before the age of 60.
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