Genetic inherited high cholesterol, known as Familial hypercholesterolaemia (FH) explained.
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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.
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
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.
Why not download our factsheet on inherited high cholesterol.