What is FH?

Genetic inherited high cholesterol, known as Familial hypercholesterolaemia (FH) explained.

Understanding Statins
Understanding Statins

Statins are cholesterol lowering drugs. Find out more about how they work, if you should take them and if they cause side effects

The Ismaili Nutrition Centre
The Ismaili Nutrition Centre

A resource for anyone who enjoys traditional foods of African, Central and South Asian, and Middle Eastern origin.


Familial Combined Hyperlipidaemia (FCH)

Often shortened to FCH, Familial Combined Hyperlipidaemia is an inherited condition affecting around one person in every hundred. People with FCH tend to have a high triglyceride level as well as a high cholesterol level.  It is unlikely that FCH is caused by a single gene alteration.  More likely it is caused by a combination of genes working individually or together to affect the levels of blood fats.   

People with FCH are at increased risk of cardiovascular (heart and circulatory) disease and there may be a history of premature heart disease or raised blood fats in close family members.

Cholesterol and triglycerides can vary a lot over time and this is often because of changes in diet, lifestyle, body weight, alcohol intake and physical activity.


Because FCH is less well understood than Familial Hypercholesterolaemia (FH) it is even more difficult to diagnose.   Triglycerides and cholesterol may not be raised until the age of 20 or 30.  At the moment genetic testing for FCH is not helpful.

Pattern of raised blood fats

People with FCH have a unique pattern of raised blood fats which put them at high risk of cardiovascular disease.  This includes:

  • raised levels of VLDL particles – these are triglyceride rich particles produced by the liver
  • elevated ApoB levels (each VLDL particle contains one particle of ApoB, so more VLDL means more ApoB)
  • fasting triglyceride levels above 1.5mmol/l
  • LDL cholesterol particles that are smaller and more compact (dense) than normal  


A healthy diet and lifestyle are a key part of treatment and this includes limiting alcohol and sugary foods as well as reducing saturated fats and replacing them with unsaturated fats.

The need for and the type of medication prescribed will depend on the individual’s levels of triglycerides and cholesterol.  Ideally people with FCH should be diagnosed and treated in a lipid clinic with regular follow up. 

Close relatives of people with FCH should be encouraged to have a fasting blood test to check for their levels of both cholesterol and triglycerides.   

Why not download our factsheet on inherited high cholesterol.

Essential Downloads

Click on the links below to download our fact sheets.

» Medicines

» Statins

» Fibrates

» Resins

Got a question? (supporter)
Got a question?

If you have a question about becoming a supporter of HEART UK then please contact us; call 01628 777 046 or email development@heartuk.org.uk

Your stories

Read about someone who has experienced the difficulties of living with FH on a daily basis.

UCLP Resources

We have resources for both health professionals and their patients.

You can download the UCLP©​ leaflet or contact the HEART UK helpline for additional copies (ask@heartuk.org.uk) or tel 0345 450 5988      

All our other UCLP© resources are online/downloadable from these pages: UCLP resources, Health professional resources and publications, Joint activities/UCLP©