Points you must keep in mind if you have a family history of high cholesterol New Delhi, May 31, 2016: Typically if someone is diagnosed with cardiovascular ailments when they are below the age of 55 years (men) and 65 years (women) they are believed to be suffering from premature heart disease. “In such patients, the prevalence of dyslipidemia, a condition characterised by high cholesterol levels without any evident symptoms is about 75-85%”, said Padma Shri Awardee Dr KK Aggarwal, President, Heart Care Foundation of India and Honorary Secretary General IMA. Fifty-four percent of all patients with premature heart disease and 70% of those with a lipid abnormality have a familial disorder. Screening for lipids is therefore recommended for first-degree relatives of patients with MI (particularly if premature). Screening should begin with a standard lipid profile, and if normal, further testing should be done for Lp(a) and apolipoproteins B and A-I. Approximately 25% patients with premature heart disease and a normal standard lipid profile will have an abnormality in Lp(a), or apo B. Elevated apo A-1 and HDL are likewise associated with decreased CHD risk. First-degree relatives refer to brothers, sisters, father, mother; Second-degree relatives are aunts, uncles, grandparents, nieces, or nephews. The third-degree relatives refer to first cousins, siblings, or siblings of grandparents. Familial hypercholesterolemia (FH) is a genetic disorder, characterised by high cholesterol, specifically very high LDL (or the bad cholesterol) levels, and premature heart disease. Patients may develop the premature cardiovascular disease at the age of 30 to 40. Heterozygous FH is a common genetic disorder, occurring in 1:500 people in most countries. Homozygous FH is much rarer, occurring in 1 in a million births. Heterozygous FH is normally treated with drugs. Homozygous FH often does not respond to medical therapy and may require apheresis or liver transplant. To detect familial high cholesterol levels, one must do the universal screening at age 16. The cholesterol levels in heterozygous patients are between 350 to 500 mg/dL, and in homozygous, the levels are between 700 to 1,200 mg/dL. Awareness must be created about the fact that food of plant origin has no cholesterol and it is only the food derived from animal by-products which is high in cholesterol. In addition to that trans-fat is more dangerous than saturated fat and it reduces good cholesterol and increases bad cholesterol in the body. People who have family history must not only take treatment but also should make lifestyle changes in order to prevent other associated risk factors of heart disease such as diabetes, hypertension and obesity.