Many people with familial hypercholesterolemia (FH) are young and appear otherwise healthy, yet their arteries may tell a different story. With FH, the body can’t keep up with cholesterol levels. As a result, high levels of bad cholesterol may have been in their bodies – often unchecked – since they were born.

Over time, this can damage the blood vessels and block the arteries that supply the heart and brain. Cholesterol can also build up in the eyes, the skin, the liver and the tendons. Finding and treating FH early is critical.

If someone doesn’t know they have FH, the condition is often first suspected after someone has had a heart attack or stroke at a very early age, often before age 50.

The risk for problems is even higher in people who have other risk factors such as smoking or diabetes.

Different Types of Familial Hypercholesterolemia:

Types of FH

Familial hypercholesterolemia, or FH, runs in families (a genetic condition). It happens when there is a change in one of several genes in the body.

There are two types of FH:

Heterozygous FH (HeFH) is more common. People with HeFH have one FH gene from one parent.

Homozygous FH (HoFH) is less common. People with HoFH inherit two FH genes, one from each parent. In this case, both parents have FH. This is much more serious and needs early detection in childhood.

People with HoFH can have LDL cholesterol levels more than 4 times higher than normal, which raises their risk of heart disease even more. Events can happen at younger ages, even in childhood. HoFH is harder to treat.

With both types of FH, treatment to lower LDL cholesterol is important to prevent heart attacks, stroke and related death.