Familial Hypercholesterolemia: Causes, Risks, and How Medications Help

When you have familial hypercholesterolemia, a genetic disorder that prevents your body from removing low-density lipoprotein (LDL) cholesterol from the blood. Also known as FH, it means your cholesterol levels are high from birth—no matter how healthy you eat or how much you exercise. This isn’t just about high numbers on a lab report. It’s a ticking clock for your heart. People with untreated FH have up to a 20 times higher risk of heart attack before age 50. Half of men with FH have a heart attack by 50. For women, it’s often by 60. And many don’t even know they have it until it’s too late.

Familial hypercholesterolemia runs in families. If one parent has it, each child has a 50% chance of inheriting it. That’s why screening kids as young as 2 is recommended in many countries. It’s not just about cholesterol—it’s about LDL cholesterol, the "bad" cholesterol that builds up in artery walls and turns them into narrow, stiff pipes. Over time, that buildup leads to blockages, angina, or sudden heart attacks. You can’t see it. You might not feel it. But your arteries are silently clogging.

That’s where statins, a class of drugs that block cholesterol production in the liver come in. They’re the first line of defense. But FH often needs more. Some people need ezetimibe to block cholesterol absorption in the gut. Others need PCSK9 inhibitors—injectables that help the liver pull more LDL out of the blood. And for the most severe cases, a procedure called LDL apheresis literally filters cholesterol out of the bloodstream like dialysis. It’s not a cure, but it’s a lifeline.

What you’ll find in the posts below isn’t just a list of drugs. It’s real-world insight into how medications like statins work alongside lifestyle changes, what side effects to watch for, and how to spot when your treatment isn’t enough. You’ll see how people manage FH alongside other conditions—like high blood pressure or diabetes—that make heart disease risk even worse. These aren’t theoretical guides. They’re practical, tested strategies from people living with this condition and the pharmacists who help them every day. Whether you’re newly diagnosed, helping a family member, or just trying to understand why your cholesterol won’t budge, this collection gives you what you need to act—before it’s too late.