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What It's Like Having High Cholesterol in the Family
Matt Ito, PharmD, of Portland, Oregon, is active in raising awareness about high cholesterol for a very good reason: He himself inherited a dangerous high cholesterol condition called familial hypercholesterolemia, or FH, which affects more than 600,000 people in the United States.
Itos advice on keeping cholesterol levels under control to protect your heart health comes from a very personal point of view because hes had to deal with familial hypercholesterolemia since he was a teen.
High Cholesterol: A Heart Disease Risk You May Not Know You Have Ito first found out that he had inherited high cholesterol when he was only 14 years old. “My mother happened to get her cholesterol checked.
She has a family history of premature cardiovascular disease, and she was diagnosed with FH, he recalls. Both Ito and his two older brothers then got tested; he had inherited high cholesterol, but they had not.
They later learned that his younger sister has FH as well. In families with familial hypercholesterolemia, theres a one in two chance that a child will have the condition.
“I passed it on to my daughter, who is 18 now, and we found out when she was 10. My son does not have FH,” says Ito.
Inherited High Cholesterol Medication When Ito originally found out that he had FH, statins were not yet available as a treatment for high cholesterol.
“Statins didn’t come out until 1986 or so, when I was getting out of pharmacy school,” he explains. Initially, children with the condition were simply given dietary restrictions on fat intake and told to exercise.
Eventually, bile acid sequestrants, one of the first of the cholesterol-lowering drugs, became available — though not for children, Ito notes. “I was on triple therapy,” he says.
“A statin, a cholesterol absorber — Zetia — and a bile acid sequestrant,” he explains. All of these drugs are now approved by the FDA for children, too.
His current regimen includes a new treatment available for people with familial hypercholesterolemia: a medication in a new class of cholesterol-lowering drugs called PCSK9 inhibitors. His LDL has since dropped to a healthy level of less than 25 milligrams per deciliter (mg/dL).
Ito sees both a cardiologist and a primary care doctor, and gets his cholesterol tested every six months, although when a patient first starts on medication they have to be checked more frequently.
Ito suffered a major heart attack and had triple bypass surgery, although he was on two types of medication at the time.
His LDL cholesterol, or bad cholesterol, was still very high — 250 mg/dL, which more than twice the normal level. Thats why hes now on additional medication.
Lifestyle Choices Help Keep Cholesterol Down If your cholesterol levels meet the following guidelines, theyre considered healthy: LDL cholesterol: below 100 mg/dL (in the absence of diabetes) HDL cholesterol: above 40 mg/dL for men or 50 mg/dL for women If your numbers are not in these ranges, youre not alone.
As many as one out of every three American adults have high LDL cholesterol, according to the Centers for Disease Control and Prevention (CDC).
While medication can be effective, Ito says that unfortunately many with inherited high cholesterol do not get to their LDL goal, even with medication.
The first way to begin getting control over your cholesterol levels is by focusing on your diet. “I’m very strict about fat and cholesterol intake,” Ito says.
After the heart attack, he became even stricter. “I cut out red meat and eat only chicken and fish,” he says.
He also reduced his sodium intake to below 2,000 mg a day. “That is a challenge!” Ito acknowledges, adding, “You really have to read labels.” Changing the way you eat can be daunting, too.
“Cooking at home is a challenge because others at home don’t have FH, Ito says.
RELATED: What Do I Need to Know About My Diet and Cholesterol? To help keep his cholesterol levels down, he also exercises at least 30 minutes almost every day for cardiovascular fitness.
“I do have heart failure now, so part of improving heart function is to keep up with aerobic training.
In general, with FH you have to also control blood pressure and diabetes, and not smoke, because FH increases — by three to five times — the risk of heart disease,” Ito says.
A Medical Background Helps Him Take High Cholesterol Seriously Does his pharmaceutical and medical knowledge help Ito successfully manage his inherited high cholesterol? “Definitely!” he says.
“What is tough is if a patient doesnt have an understanding of how disastrous this condition can be.
Having medical knowledge really helps.” He understands that many people with familial hypercholesterolemia will still go on to have a heart attack like he did, or a stroke.
Ito says, “Its tough to overcome lifelong exposure to high cholesterol,” which begins at birth for those with inherited high cholesterol. By teaching pharmacy and nursing students, Ito is helping to raise awareness about inherited high cholesterol in his community.
“One of my goals after my heart attack was to focus on FH,” he says. Ito was president of the National Lipid Association from 2013 to 2016, and works with the FH Foundation as well.
“My hope is that we can reach the lives of many and get information out there so they will get tested — and get family to get tested, too, if theyre positive.
It can be passed on easily to other family members,” says Ito. Why not get your cholesterol levels tested, along with your family? What you find out could make a big difference for your heart health.