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What Is the Difference Between Familial and Acquired High Cholesterol?

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By Editorial Team

3 min read

Cholesterol is a type of fat (lipid). It is produced by the liver. It has many important functions such as digesting food and making hormones. But, if the amount of cholesterol in your blood is higher than normal, it can lead to serious problems.1

Types of cholesterol

The 3 types of cholesterol in the body are:2

  • High-density lipoprotein (HDL) cholesterol: This is the “good” cholesterol. It can help get rid of extra cholesterol from the blood.
  • Low-density lipoprotein (LDL) cholesterol: This is a “bad” cholesterol. Having too much LDL cholesterol can block arteries.
  • Very low-density lipoprotein (VLDL) cholesterol: This is also a “bad” cholesterol. It carries a type of fat called triglyceride which can build up on the arteries.

High cholesterol is also called hyperlipidemia. This term refers to high (hyper-) amounts of fat (lipid) in the blood (-emia). Hypercholesterolemia is a type of hyperlipidemia where the amount of LDL is high. Another type of hyperlipidemia is hypertriglyceridemia. In this type, there are high amounts of triglycerides in the blood.1,3,4

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Inherited high cholesterol

Familial hypercholesterolemia (FH) is high cholesterol that is genetic or inherited. If one or both of your birth parents have FH, it can increase your chances of having FH. People with FH have high LDL cholesterol.3,5,6

Another type of genetic high cholesterol is familial hypertriglyceridemia. People with this disorder have high amounts of VLDL. This is caused by the pancreas making too much VLDL. Familial hypertriglyceridemia can lead to pancreatitis (inflammation of the pancreas).4

People with genetic high cholesterol usually have high cholesterol from a young age. High cholesterol can block the arteries by creating a buildup. This can put you at a higher risk of developing heart disease or getting a heart attack at a young age.3

What causes familial hypercholesterolemia (FH)?

Our genes contain instructions for making different proteins. One protein, called LDL receptor, is responsible for taking LDL cholesterol out of the blood. In people with FH, the gene for making this protein is changed. As a result, more LDL cholesterol stays in the blood.3

We have 2 copies of every gene, 1 from each parent. People who get the FH gene from both parents have a more severe form of FH.3,7

What are the chances of having FH?

In the United States, roughly 1 out of 250 adults have inherited high cholesterol. If one of your parents has FH, then you have at least a 50 percent chance of inheriting FH. If both of your parents have FH or either of them has 2 copies of the FH gene, that increases your chances of getting FH and your FH being severe. But the more severe form of FH is less common.3,5-7

Acquired hyperlipidemia

It is also common for people to have high cholesterol without having the genes that cause high cholesterol. This is called acquired hyperlipidemia or hypercholesterolemia. Some of the causes of acquired hyperlipidemia are:6

  • A high-fat diet
  • Lack of exercise
  • Old age

It is also possible for other diseases to cause acquired hypercholesterolemia. For examples, having uncontrolled diabetes or hypothyroidism (low thyroid hormones) can lead to hyperlipidemia.8

Treatments for high cholesterol

Both acquired and genetic forms of high cholesterol have similar treatments. Lifestyle changes and certain medicines can help keep your cholesterol in check.7,8

Statins are a class of drugs that are most commonly used to treat high cholesterol. Some people experience side effects from statins. In their case, their doctor may prescribe another class of drugs called PCSK9 inhibitors.7,8

Along with medicine, doctors recommend you eat fewer fatty foods to help lower your cholesterol. Fried foods, dairy products, and meats are just some of the foods that contain unhealthy fats. Increasing physical activity should also help lower cholesterol.6

Untreated high cholesterol can lead to serious problems. High cholesterol can block the arteries and stop blood flow. It can lead to a heart attack or a stroke. You can reduce these risks through:3

  • Early diagnosis
  • Treatment
  • Lifestyle changes
Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.

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