Hi, thank you for your question. Yes, high cholesterol can be genetic. There is a condition known as familial hypercholesterolemia (FH), which happens as a result of genetic defect on chromosome 19. This makes it harder for the body to remove LDL (“bad”) cholesterol from the blood and results in LDL levels.

If one of your parents has FH, there is a 50% chance that you might have it. Things that may suggest that someone has FH include having family history of FH or heart disease at a young age, high cholesterol levels at a young age, high blood cholesterols which resists treatment, angina (chest pain) and xanthomas (cholesterol deposits around your hands, elbows, knees and eyes).

FH is diagnosed through a series of tests, such as physical examination, blood tests, genetic tests and heart tests. There is no cure for FH. Treatment of FH aims to prevent complications of high cholesterol such as heart disease and strokes. It is important that people with FH make wise food choices, which involves reducing intake of saturated and trans fat, and increasing the intake of fibre.

Also, they should exercise regularly. Moderate-intensity exercise for at least 30 minutes 5 times a week or vigorous aerobic exercise for 20 minutes 3 times a week is recommended. Some examples of moderate-intensity exercises includes brisk walking, swimming and cycling. Shedding those extra weight and kicking the smoking habit are essential as well.

Despite these lifetyle modifications, most people with FH will need medications such as statins. Statin work by decreasing LDL cholesterol and triglycerides, and increasing HDL cholesterol slightly. Other medications include bile acid binding resins, cholesterol absorption inhibitor, combination of statin and cholesterol absorption inhibitor, fibrates, niacin, omega-3 fatty acids supplements and combination of calcium-channel blocker and statin.

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