{"id":53162,"date":"2025-07-15T13:23:47","date_gmt":"2025-07-15T17:23:47","guid":{"rendered":"https:\/\/blackhealthmatters.com\/?p=53162"},"modified":"2025-10-21T14:40:00","modified_gmt":"2025-10-21T18:40:00","slug":"racial-differences-for-inherited-high-cholesterol","status":"publish","type":"post","link":"https:\/\/blackhealthmatters.com\/racial-differences-for-inherited-high-cholesterol\/","title":{"rendered":"There Are Racial Differences in Inherited High Cholesterol"},"content":{"rendered":"<p>For years, high<a href=\"https:\/\/blackhealthmatters.com\/best-foods-to-improve-your-cholesterol-numbers\/\"> cholesterol<\/a> has been simplified into a lifestyle problem. People are told to eat better, move more, and their numbers should fall in line. That advice is everywhere. But for many families within our community, the story isn\u2019t that simple. Beneath the surface of heart-healthy tips lies a genetic condition called familial hypercholesterolemia (FH) that pushes LDL cholesterol to dangerous levels from childhood. It\u2019s more common than most realize, yet rarely named in clinical settings, conversations, or community health efforts.<\/p>\n<h2>What Is Familial Hypercholesterolemia?<\/h2>\n<p>Familial hypercholesterolemia (FH) is one of the most common inherited conditions in the United States, affecting roughly 1 in 250 adults, according to the <a href=\"https:\/\/www.cdc.gov\/heart-disease-family-history\/about\/about-familial-hypercholesterolemia.html\">Centers for Disease Control and Prevention<\/a>. Unlike traditional high cholesterol, FH begins at birth and causes dangerously elevated LDL (low-density lipoprotein) levels that clog arteries early and aggressively.<\/p>\n<h2>What Is LDL and Why Is It Called \u201cBad\u201d?<\/h2>\n<p>LDL stands for low-density lipoprotein, which is a type of particle that carries cholesterol through your bloodstream. Cholesterol itself isn\u2019t all bad; it helps build cells and produce hormones. But when LDL carries more cholesterol than your body needs, and if there\u2019s too much, it starts to stick to the walls of your arteries.<\/p>\n<p>Over time, this buildup forms plaque, which narrows the arteries and makes it harder for blood to flow. That\u2019s how LDL contributes to heart attacks, strokes, and other cardiovascular problems. It\u2019s not \u201cbad\u201d because of what it is, it\u2019s \u201cbad\u201d because of what it does when it\u2019s out of balance.<\/p>\n<p>The <a href=\"https:\/\/www.jacc.org\/doi\/10.1016\/j.jacc.2022.07.006\">American College of Cardiology<\/a> recommends that individuals without heart disease aim for LDL levels of 100 mg\/dL or lower. For those at high risk, including people with FH, they suggest even lower targets:<\/p>\n<ul>\n<li>Under 70 mg\/dL for individuals with prior cardiovascular events.<\/li>\n<li>Under 55 mg\/dL for those at very high risk.<\/li>\n<\/ul>\n<h2>Our Community is Living the Consequences<\/h2>\n<p>Research continues to show that FH outcomes differ sharply across racial groups. Black Americans, in particular, are underdiagnosed and undertreated, leading to a higher risk of severe outcomes like heart attacks and stroke.<\/p>\n<p>A recent <a href=\"https:\/\/www.ahajournals.org\/doi\/pdf\/10.1161\/JAHA.121.020890\">study<\/a> published in the Journal of the American Heart Association found that only 61% of Black patients with FH are prescribed cholesterol-lowering medications, compared to 73% of white patients. That disparity matters, and unfortunately, cholesterol doesn\u2019t wait for equity.<\/p>\n<p>The same study highlighted additional challenges:<\/p>\n<ul>\n<li>82% of Black adults with FH also have high blood pressure (vs. 50% of white patients).<\/li>\n<li>39% live with diabetes (compared to 15%).<\/li>\n<li>16% are current smokers, nearly double that of their white counterparts.<\/li>\n<\/ul>\n<h2>A Larger Pattern of Risk<\/h2>\n<p>High cholesterol is one thread in a much larger fabric of cardiovascular risk in our community. The<a href=\"https:\/\/newsroom.heart.org\/news\/cardiovascular-health-risks-continue-to-grow-within-black-communities-action-needed\"> American Heart Association\u2019s 2025 Statistical Update<\/a> reveals that:<\/p>\n<ul>\n<li>Almost 60% of Black adults live with some form of cardiovascular disease.<\/li>\n<li>Over half of all heart failure hospitalizations in adults under 50 involve Black patients.<\/li>\n<li>Stroke rates are highest among Black men and women, with 5.4% of Black women and 4.8% of Black men affected.<\/li>\n<\/ul>\n<p>It\u2019s not that these numbers are inevitable; it\u2019s that FH isn\u2019t being caught early, and many providers still rely solely on lifestyle assumptions instead of screening for genetics.<\/p>\n<h2>Kids Are Being Missed Too<\/h2>\n<p>FH doesn\u2019t just show up in adulthood; it\u2019s there from the start.\u00a0The\u00a0<a href=\"https:\/\/www.cdc.gov\/cholesterol\/testing\/index.html\" target=\"_blank\" rel=\"noopener\">CDC<\/a> recommends screening children between the ages of nine and 11 if there\u2019s a family history of early heart disease or cholesterol issues.\u00a0But only 30% of kids born with FH are diagnosed early, and for Black children, the delays are even longer.<\/p>\n<p>When a parent has FH, each child has a 50% chance of inheriting it. That means genetic testing and early cholesterol panels should be routine, but they\u2019re not.<\/p>\n<h2>Getting the Right Treatment Isn\u2019t Always Easy<\/h2>\n<p>For most people with high cholesterol, doctors prescribe statins, medications that help lower those numbers and reduce the risk of heart problems. But when cholesterol stays high because of a genetic condition like FH, statins often aren&#8217;t enough.<\/p>\n<p>That\u2019s where newer treatments come in. Medications like Praluent and Repatha are part of a group called PCSK9 inhibitors. They\u2019re designed to help the body remove stubborn LDL cholesterol, the kind that clogs arteries even when people eat healthy and exercise. These drugs can make a real difference for people with FH, but without a confirmed case of FH, especially through genetic testing, doctors often won\u2019t prescribe them. And that\u2019s where the gap widens.<\/p>\n<p>A 2025 <a href=\"https:\/\/www.cell.com\/ajhg\/fulltext\/S0002-9297(25)00238-1?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0002929725002381%3Fshowall%3Dtrue\">study<\/a> published in The American Journal of Human Genetics found that only 27.7% of Black patients received a documented genetic diagnosis, compared to 63.1% of white patients, suggesting that our community is routinely overlooked for the very testing that opens the door to these advanced medications.<\/p>\n<h2>Breaking the Cycle<\/h2>\n<p>Familial hypercholesterolemia (FH) is often overlooked, especially in Black communities, where delays in diagnosis are common and access to advanced treatment is inconsistent. Knowing your numbers and being proactive can make a real difference. Here\u2019s where to begin:<\/p>\n<ul>\n<li>Getting a full lipid panel, including LDL, HDL, triglycerides, and, if available, apolipoprotein B.<\/li>\n<li>Asking about FH directly, not all providers bring it up.<\/li>\n<li>Encourage your family to get screened, especially younger relatives.<\/li>\n<li>Pushing for genetic testing if cholesterol levels are high, even with a healthy lifestyle.<\/li>\n<\/ul>\n<p>The silence surrounding FH isn\u2019t solely a medical issue; it\u2019s systemic. And it\u2019s time to name it, track it, and treat it with the urgency it deserves. Your numbers matter. Your family history matters. And your voice in the exam room can change everything.<\/p>\n<p>Resources<\/p>\n<p><a href=\"https:\/\/www.cdc.gov\/heart-disease-family-history\/about\/about-familial-hypercholesterolemia.html\">About Familial Hypercholesterolemia | Heart Disease, Family Health History, and Familial Hypercholesterolemia | CDC<\/a><\/p>\n<p><a href=\"https:\/\/www.jacc.org\/doi\/10.1016\/j.jacc.2022.07.006\">2022 ACC Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: A Report of the American College of Cardiology Solution Set Oversight Committee | JACC<\/a><\/p>\n<p><a href=\"https:\/\/www.ahajournals.org\/doi\/pdf\/10.1161\/JAHA.121.020890\">Racial Disparities in Modifiable Risk Factors and Statin Usage in Black Patients With Familial Hypercholesterolemia<\/a><\/p>\n<p><a href=\"https:\/\/newsroom.heart.org\/news\/cardiovascular-health-risks-continue-to-grow-within-black-communities-action-needed\">Cardiovascular health risks continue to grow within Black communities, action needed | American Heart Association<\/a><\/p>\n<p><a href=\"https:\/\/www.cdc.gov\/cholesterol\/testing\/index.html\">Testing for Cholesterol | Cholesterol | CDC<\/a><\/p>\n<p><a href=\"https:\/\/www.cell.com\/ajhg\/fulltext\/S0002-9297(25)00238-1?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0002929725002381%3Fshowall%3Dtrue\">Exclusion-based exome sequencing in critically ill adults 18\u201340 years old has a 24% diagnostic rate and finds racial disparities in access to genetic testing: The American Journal of Human Genetics<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>For years, high cholesterol has been simplified into a lifestyle problem. People are told to eat better, move more, and their numbers should fall in line. That advice is everywhere. [&hellip;]<\/p>\n","protected":false},"author":28,"featured_media":53223,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6548,6551,1957,6554],"tags":[3159,5884,5882,5881,5878,5879,4126,5880,4832,5883],"class_list":["post-53162","post","type-post","status-publish","format-standard","has-post-thumbnail","category-condition","category-diabetes-type-1-type-2","category-health","category-heart-disease","tag-cardiovascular-health","tag-cholesterol-awareness","tag-cholesterol-screening","tag-familial-hypercholesterolemia","tag-fh","tag-genetic-high-cholesterol","tag-health-equity","tag-heart-disease-risk","tag-ldl-cholesterol","tag-underdiagnosed-conditions"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.9 (Yoast SEO v26.9) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>There Are Racial Differences in Inherited High Cholesterol - Black Health Matters<\/title>\n<meta name=\"description\" content=\"Familial hypercholesterolemia is a genetic condition that causes high LDL cholesterol from birth. 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