Is high cholesterol genetic? (And can it be prevented?)

Key Points:

• High cholesterol occurs when fatty substances build up in blood vessels, making it harder for the heart to pump blood. This can lead to problems like heart disease and stroke.
• One form of high cholesterol—familial hypercholesterolemia—is strongly linked to genetics. But lifestyle and environmental factors also play a role.
• You can manage high cholesterol through diet, exercise and medication.

You have your grandma’s eyes, your dad’s dimples and your Aunt Betty’s chin. But did you also inherit their high cholesterol? This may be true for some people, as family members can pass one form of high cholesterol down through their genes. You can also “inherit” family habits that contribute to cholesterol levels.

Treating high cholesterol can lower the risk of complications, including heart disease and stroke.

So if you’re one of the two in five US adults with high cholesterol, you know how important it is to manage your condition.

Read on to learn more about the familial part of the puzzle.

And if you need a convenient way to refill an existing cholesterol medication prescription, Dr. B has you covered. Learn about how our online health platform works or start an online cholesterol consultation.

What does it mean to have high cholesterol?

Cholesterol is a waxy substance that can build up in blood vessels—kind of like gunk in pipes. Over time, that buildup can impact blood flow or cause a clog. It also makes it harder for the heart to pump blood.

There are two types of cholesterol—LDL and HDL. People with high cholesterol have too much LDL cholesterol in their blood vessels. They may also have a high level of triglycerides—a type of fat.

• Low-density lipoprotein (LDL) cholesterol is known as “bad” cholesterol. This type builds up in blood vessels and may cause blockages.
• High-density lipoprotein (HDL) cholesterol is “good” cholesterol. High HDL levels lower the risk of heart problems.
• Triglycerides are a type of fat in your blood that the body uses for energy.

Your body makes all the cholesterol it needs to produce hormones and digest fatty food. That’s why it’s important not to eat too many foods with high levels of cholesterol.

High-cholesterol foods include:

• Red meat and other animal products
• Full-fat dairy products
• Fried foods
• Processed sweets

What causes high cholesterol?

Different factors, like genetics, environment and lifestyle can raise cholesterol. It also becomes more common as you get older.

Lifestyle factors

People are at an increased risk of high cholesterol if they eat a high-fat diet, don’t exercise regularly or smoke. You can control some of the factors that may contribute to high cholesterol.

Watching your diet, exercising and quitting smoking can significantly impact your cholesterol levels.

Environmental factors

Some habits that contribute to high cholesterol can sort of be inherited because we learn how to eat and care for ourselves from our family and close friends. So people with families that consume a lot of fast food or smoke may have more difficulty with health problems like high cholesterol.

Genetics and other health conditions

Other conditions can make it hard to control cholesterol levels. Obesity and diabetes are both associated with higher cholesterol levels. One form of high cholesterol is closely related to genetics.

Familial hypercholesterolemia (FH) is a genetic condition affecting one in 250 people that makes it much more likely to develop heart disease at a younger age.

People with FH have a much higher LDL level in their blood. So diet, exercise, and weight control aren’t enough to manage their cholesterol and medication is (almost always) required. If diagnosed early enough, medication can reduce the risk of heart disease by nearly 80%.

How do I know if I have cholesterol?

The tricky thing about high cholesterol is that you may not even know you have it. It doesn’t always cause symptoms—but it can still cause a lot of damage. Your doctor can run a blood test cholesterol screening to determine your total cholesterol level. This number takes into account levels of HDL, LDL and triglycerides.

This is how physicians categorize total cholesterol levels:

• Healthy: Less than 200 mg/dL
• At risk: Between 200 and 240 mg/dL
• High: Over 240 mg/dL

Why is high cholesterol a problem?

Treating high cholesterol—even if you don’t have symptoms—is crucial because blockages can cause stress on your heart and blood vessels. This means you have a higher risk of developing serious health problems.

Conditions at increased risk include:

• Stroke
• Angina (chest pain)
• Coronary artery disease (CAD)
• Heart attack
• Heart disease
• Kidney problems

How do I prevent high cholesterol?

The good news is that you can lower your chances of developing high cholesterol by following healthy habits.

These steps can keep cholesterol under control:

• Get your cholesterol checked regularly—especially if you have a family history of high cholesterol.
• Eat a balanced, low-fat diet with many whole grains, fresh fruits and vegetables and lean proteins.
• Follow a sensible exercise plan that you enjoy (at least 150 minutes per week).
• Limit alcohol intake, which means no more than one drink per day for women or two per day for men.
• Manage other health conditions, like diabetes or obesity, with your provider’s help.

What treatments are available for high cholesterol?

If you have high cholesterol, it’s important to eat a healthy diet and exercise regularly. Some people will also need to take medications. Statins are a kind of drug that can help lower cholesterol levels by as much as 50%.

If you are concerned about your cholesterol levels or have a family history of high cholesterol, talk to a medical provider. They’ll check your cholesterol levels and discuss ways to manage them if necessary.

If you already have a prescription for cholesterol medication, taking it exactly as prescribed is essential. If you need a more convenient way to refill your prescription, Dr. B can help.

Fill out a short online health questionnaire. A licensed provider will review your answers. If a refill is appropriate, they’ll send it to the pharmacy of your choice.

Dr. B is available every day of the year and across all 50 US states. So come to us when you need convenient, seamless online treatment for common conditions like high cholesterol. We’re here for your health!

Sources

Centers for Disease Control and Prevention. (2023). High cholesterol facts.

Centers for Disease Control and Prevention. (2023). Familial hypercholesterolemia.

Hill M.F., et al. (2023). Hyperlipidemia. StatPearls Publishing.

Hoover L. E. (2019). Cholesterol management: ACC/AHA updates guideline. American Family Physician.

Rosenson, R. (2021). Patient education: High cholesterol and lipids. UpToDate.