The most common causes of high cholesterol include obesity, poor eating habits, lack of physical activity and a family history of heart disease. However, heredity can also influence your cholesterol levels. When it does, it's known as familial hypercholesterolemia, a disorder resulting in high cholesterol levels from birth. One in 500 individuals carries one altered gene causing familial hypercholesterolemia, according to the National Genome Research Institute. It is also possible but more rare for a person to inherit the gene mutation from both parents. These Individuals have a much more severe form of hypercholesterolemia, with heart attack and death often occurring before age 30.
Familial Hypercholesterolemia
Familial hypercholesterolemia is the result of a mutant gene that when normal, clears excess low-density lipoprotein -- LDL -- cholesterol from your blood. High LDL levels increase your risk of heart disease, heart attack and stroke. People with familial hypercholesterolemia are more likely to have a heart attack at a younger age due to the unusually high levels of cholesterol in their body. If you are among those with this condition, your doctor typically combines cholesterol-lowering drugs, diet, weight-loss and exercise to reduce your health risk.
Statins
Statins are the first and most effective choice for treating familial hypercholesterolemia. These drugs work by slowing the production of cholesterol and increasing your liver's ability to clear excess LDL from your bloodstream. Medications in this class include atorvastatin, lovastatin, simvastatin, fluvastatin, pravastatin and rosuvastatin. Each of these drugs come in various doses that your doctor can adjust to meet your needs. Common side effects include muscle, joint and stomach pain, nausea, diarrhea and constipation. In rare cases, liver and muscle damage may occur.
Bile Acid Sequestrants
Bile acid sequestrants, also known as bile acid binding resins, reduce your cholesterol by binding to the cholesterol in your bile, flushing it from your body via bowel movements. This prompts your liver to use excess cholesterol in an effort to produce more bile. Drugs in this class include colesevelam, cholestyramine and colestipol. You may experience side effects such as constipation, bloating, diarrhea, vomiting, stomach pain and nausea.
Ezetimibe
Ezetimibe, at the time of publication, is the only drug known as a cholesterol absorption inhibitor. While your small intestine absorbs cholesterol from the food you eat, ezetimibe is busy absorbing this cholesterol from your bloodstream. You may experience fatigue, diarrhea, stomach pain or joint and back pain when first starting this cholesterol-lowering drug.
Combining Medications
Your doctor may feel it's necessary to combine one or more of these drugs to effectively treat your condition. This depends on how severe your case of familial hypercholesterolemia is. Both bile acid sequestrants and cholesterol absorption inhibitors can be combined with statins and each other. Another drug, Vytorin, is a pharmaceutical combination of simvastatin and ezetimibe. This slows cholesterol production while simultaneously absorbing the excess from your blood.
