It is actually both!
High cholesterol can either be due to genetic issues or lifestyle habits. It is essential to know this because the course of remedy for high cholesterol greatly depends on its nature.
“High cholesterol is both a genetic issue and a lifestyle disease for some patients; there is some genetic abnormality which predisposes them to high cholesterol levels like familial hypertriglyceridemia. They have their high cholesterol level because of a genetic problem and whatever they do, their cholesterol remains high,” says Dr Sanjeev Chaudhary, Director - Cardiology, Marengo Asia Hospitals, Gurugram.
“And in most of these patients, lifestyle modification cannot result in normal cholesterol. So those patients with the genetic predisposition to high cholesterol will continue to have high cholesterol until unless they take medicines,” he adds.
Familial hypercholesterolemia is due to a defect in chromosome 19
High cholesterol can be due to either genetic predisposition or dietary issues. A genetic defect in chromosome 19 leads to familial hypercholesterolemia. It's either homozygous (defect found in both parents' genes) or heterozygous (defect in only one parent's gene) in nature, explains Dr Bharat Vijay Purohit, Senior Consultant Interventional Cardiologist & Director of Cath Lab, Yashoda hospitals, Hyderabad.
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In case of homozygous hypercholesterolemia, cholesterol deposits on elbow knee joint (xanthomas) or around eyelids (xanthelasma) or around iris in eye(corneal arcus) are seen in childhood, Dr Purohit adds.
Homozygous hypercholesterolemia, which means you have two sets of the faulty genes-one from each parent, increases the risk of developing heart diseases early. In this case, it gets difficult for the body to remove the LDL or the low density lipoprotein cholesterol.
How to diagnose whether it is a genetic predisposition or a lifestyle disorder?
“Usually in genetic predisposition the cholesterol levels are very high as compared to those who have this because of lifestyle disorder and secondly, there are genetic markers also available which can be tested to find out whether the patient has genetic predisposition or it is a lifestyle disorder. Those tests are costly and there are specific indications to use those tests,” explains Dr Chaudhary. He recommends consulting the doctor on whether you need to be screened for a familial genetic predisposition for high cholesterol or not.
So, what can be done?
“The good point is that there are specific therapies available for them, medicines can work. Now gene therapy is also a very big thing which is coming up and shortly, we will have genetic treatment so that they are permanently cured but till then they can have medicines to reduce their cholesterol levels,” he says.
For others who do not have this genetic predisposition, high cholesterol can also happen due to unhealthy lifestyle habits. It can be because of bad eating habits, lack of exercise, diabetes, and maybe smoking and a sedentary lifestyle. So, for those patients, lifestyle modification is going to work and if they are very strict in their lifestyle modification, they can have normal cholesterol levels without medicines,” according to Dr Chaudhury.
Unhealthy diet contributes to high cholesterol
Dr Purohit explains that an unhealthy diet also contributes to high cholesterol. “Diet rich in saturated fats (e.g. pork lamb poultry with skin whole egg, unskimmed milk, Coconut oil, palm oil, etc.) and trans fat ( cookies, donuts, pastries, potato chips, buttered popcorn etc.) increase the risk of high cholesterol,” says Dr Purohit. “Dietary guidelines suggest limiting dietary cholesterol intake to less then 300 mg per day,” he adds.
The takeaway message
“It is recommended to do the first lipid profile test around the age of 10 years and then in every 5 years,” recommends Dr Purohit.
The experts have urged to know the root cause of why the cholesterol level is rising and have warned that whatever the cause may be, high cholesterol is a silent killer, especially when it poses life-threatening risk to the heart.