A healthy living blog from Marshfield Clinic Health System

Inherited cholesterol: Early screening for children matters

High cholesterol is a common health condition for adults. However, like your hair or eye color, cholesterol issues can be inherited and are largely an undiagnosed problem. If inherited cholesterol is left untreated, you have 20 times the risk of developing heart disease, according to the American Heart Association.inherited cholesterol

What is inherited cholesterol?

Inherited cholesterol is known as familial hypercholesterolemia (FH). FH is a condition that makes it harder for your body to get rid of lipoprotein (LDL) cholesterol from your blood. LDL, also known as bad cholesterol, tends to be the cholesterol that collects inside the arteries and veins. It narrows the passageways and increases your risk of heart attack or stroke at an early age.

“The strongest indicator of high cholesterol in childhood is family history for heart disease and high cholesterol,” said Dr. Richard Willes, pediatric cardiologist at Marshfield Children’s. “Severe forms of high cholesterol are genetically inherited and require genetic or lipid testing.”

It’s an undiagnosed problem

According to Johns Hopkins School of Medicine, the biggest problem with FH is that more than 90% of people who have inherited cholesterol haven’t been diagnosed, which means you should pay careful attention to your family history.

“Inherited cholesterol is often silent and we don’t know it’s an issue until there is a significant medical event,” Willes said.

Children with increased risk factors should have cholesterol levels checked earlier (around age 10) and more often.

“This is largely genetic,” Willes said. “That is why it is important not to ignore family history and get in for screening or genetic testing. The biggest thing is early detection. If you have a family history, we encourage your child to have a screening to catch this to decide the best course of action to combat it.”


If your child has elevated cholesterol levels on a lipid test, the initial treatment will be diet and lifestyle changes. If diet and lifestyle changes aren’t reducing cholesterol, your doctor may also prescribe your child statins, which are medicines to reduce cholesterol.

“Inherited cholesterol isn’t typically fixed with lifestyle changes as it is largely a genetic problem,” Willes said. “It also isn’t a childhood obesity issue.”

Statins are safe and effective in children in combating FH.

“Statins can lower your LDL cholesterol levels by 50% or more,” Willes said. “They have been safely used to reduce the risk of heart disease for 30 years and continue to be the number one option when it comes to helping people with FH.”

To learn more about inherited cholesterol, talk to your pediatrician.

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