High cholesterol could be in the genes

Cholesterol problems or dyslipidemia is usually considered a lifestyle disease because its cause may be lifestyle-related, brought about by a high-fat and high-calorie diet, sedentary living and smoking.

Many are unaware though that the tendency for one to have high cholesterol could be in the genes. One may be born with the inherited defect to metabolize fats. Seven out of 1000 people are suffering from this inherited disease called familial hypercholesterolemia (FH).

In normal people, the liver regulates the amount of cholesterol or fat in the blood. People with FH inherits an abnormal gene which disables the liver to regulate the levels of cholesterol in the body, thus even with a healthy lifestyle, the level of cholesterol gets too high in the blood and can lead to heart attack, strokes and other problems.

One of the difficulties in treating dyslipidemia is that there are often no obvious symptoms of the condition before the development of complications such as coronary artery disease. This is the reason why it is also considered a silent killer.

People with FH are even more unfortunate because they can do nothing to prevent it. Even without other risk factors for heart attacks, and with the best of health habits, a person with FH is more likely to develop coronary artery blockages at an earlier age. Consequently, they are three to 10 times more likely to have a heart attack and die from it.

One major intervention that can prevent the sad fate of patients with FH is through treatment with cholesterol-lowering drugs. Statins are the most potent cholesterol-lowering drug in the market today and one of the most scientifically documented drugs of this class is simvastatin.

One of the major studies establishing the clinical benefits of simvastatin is the 20,000-patient Heart Protection Study (HPS) published in the Lancet. The study shows strong evidence that simvastatin, taken religiously for several years, cuts the risks of heart attacks and strokes, particularly in the high-risk population.

With the sustained use of statins, a lot of heart-related deaths could be prevented. This life-saving drug, however, comes at a high cost and this poses a challenge especially for those with familial hypercholesterolemia because they are required to take this drug religiously, possibly for life, in order to prevent life-threatening complications.

Therapharma, a division of Unilab, has introduced an affordable brand of simvastatin (Vidastat). Many local health practitioners are now conscious about health economics and are batting for high-quality but affordable drugs that cure chronic cardiovascular diseases such as elevated cholesterol.

With sustained intake of statins, the prevalence of heart attack and other diseases caused by high cholesterol is expected to decrease and people with FH would be able to lead a relatively normal life, without much fear of dying from heart attack and stroke.

Health experts, however, emphasize that maintaining a healthy lifestyle should not be compromised. Most of the cholesterol in our blood is manufactured by our body and only about 20 percent comes from our diet.

Since people with FH will not be able to get away from their genetic predisposition to the disease, the least they can do is to aggravate it by making unhealthy lifestyle choices.

Therapeutic lifestyle changes (TLC) are the mainstay in the treatment package to reduce the risk of developing heart disease or having a heart attack.

TLC refers to a set of guidelines established for the initial treatment of cardiovascular diseases. It involves a diet, which is low in saturated-fat or bad cholesterol, and is rich in fiber; weight management and regular physical activity.

Even for patients with FH, TLC can significantly help control their dyslipidemia and prevent complications.