Dyslipidemia is an abnormal increase or decrease in one or more blood lipid components, such as total cholesterol, LDL-C (bad cholesterol), triglycerides, or HDL-C (good cholesterol). It is a leading risk factor for atherosclerosis, a condition that causes heart attack, stroke, and peripheral artery disease.

Dyslipidemia can stem from diet, obesity, physical inactivity, smoking, heavy alcohol consumption, or underlying conditions like diabetes, hypothyroidism, and kidney disease. However, genetics also play a significant role.

Genetic factors influence blood cholesterol levels by about 40-60%. If a family member has dyslipidemia, especially a parent or sibling, other family members face a higher risk of developing the condition.

Some individuals experience familial hypercholesterolemia (FH), a genetic disorder caused by gene mutations affecting LDL-C cholesterol clearance. The most common mutation involves the LDLR gene, with APOB, PCSK9, and other rarer genes also implicated.

When these genes mutate, LDL-C cholesterol levels rise from childhood and persist throughout life if untreated. Adults with LDL-C levels of 190 mg/dL (4,9 mmol/L) or higher may have FH, especially with a family history of dyslipidemia or early cardiovascular disease.

Not every case of a family history of high cholesterol indicates FH. Most instances of high cholesterol in the general population result from a combination of factors, including genetics, diet, physical activity, weight, and co-existing medical conditions.

Patients undergo blood lipid tests. Photo: Tam Anh General Hospital

For individuals with multifactorial high cholesterol, a healthy lifestyle can improve blood lipid levels. However, for those with FH, lifestyle changes are important but often insufficient to reach target LDL-C levels. Therefore, most cases require long-term medication.

You maintain a relatively healthy lifestyle yet have dyslipidemia, and your father also has the condition, suggesting a potential genetic component to your high cholesterol. However, these two factors alone are insufficient for a diagnosis. A doctor needs to consider your specific LDL-C levels (especially if ≥190 mg/dL before treatment), thoroughly investigate your family history of early cardiovascular disease, and rule out other causes before making a conclusion. You should visit a hospital for an examination.

Individuals with parents or siblings who have high blood lipids, early cardiovascular disease (men under 55, women under 65), stroke, or a diagnosis of FH should proactively check their blood lipid levels. If FH is suspected, a doctor will take a family history, look for characteristic signs like tendon xanthomas and early arcus cornealis, combine this with blood lipid tests, and order gene testing.

Beyond lifestyle changes, patients may be prescribed long-term lipid-lowering drugs like statins, possibly combined with ezetimibe or PCSK9 inhibitors for high-risk groups or those with FH.

Prevent dyslipidemia by maintaining a diet rich in green vegetables, fruits, whole grains, fish, and nuts. Limit saturated fats, trans fats, organ meats, processed meats, and sugary drinks. Engage in physical activity for at least 150 minutes per week, control weight, blood pressure, and blood sugar, avoid smoking, and get enough sleep.

Dr. Duong Thi Thao, Master of Science

Cardiology Department

Tam Anh General Hospital Hanoi