THE BE T
Maybe You’re Born With It: Familial Hypercholesterolemia
High levels of low-density lipoprotein (LDL) cholesterol are
usually caused by a high-fat diet, lack of exercise and older
age. However, people with familial hypercholesterolemia (FH)
are born with it – placing them at an especially high risk of
heart disease and death.
Unfortunately 90% of people with FH don’t know they have
it and, thus, do not receive the necessary treatment. The risk
is even higher in people who have other risk factors such as
smoking or diabetes. In contrast, when FH is diagnosed and
treated early, cholesterol can be lowered and cardiovascular
risk can go down to that of the general population.
Finding and treating FH early is critical, so it is important to be
aware of the signs and symptoms. Possible signs include chest
pain; peripheral vascular disease; bumps on the tendons, around
the eyes or on the tops of hands; a white ring around the upper
and lower portions of the cornea in the eye; and carotid artery
disease. Knowing family history is also vital for early detection.
Individuals with a close family member who developed heart
disease early in life should talk with their doctor about FH.
For people diagnosed with FH, treatment is need to lower
LDL cholesterol. Along with lipid-lowering and other medications, a healthy diet, regular exercise, weight loss and
quitting smoking can be important. Visit CardioSmart.org for
more information on FH, including a new free infographic that
can be shared with patients and fact sheets offering patientfriendly tips for managing cholesterol.
Martha Gulati, MD, MS
Drinking in Moderation? Maybe Not
Drinking moderate amounts of alcohol on a regular basis may
lead to a higher risk of atrial fibrillation (AF), according to a review paper published in JACC.
While more than 100 previous studies have shown that a light
to moderate intake of alcohol can actually be good for some
people and reduce the risk of cardiovascular disease, this is not
the case when it comes to AF. According to the paper, many
people who are consuming one to two glasses of alcohol per
day may not realize they are putting themselves at risk.
The authors note that more research is needed to determine
the specific causes responsible for the relationship between
alcohol and AF. Additionally, more research is needed to determine whether patients with irregular heartbeats should avoid
“People who continue to consume alcohol at moderate rates
may also notice their irregular heartbeats become more frequent,”
explains Peter M. Kistler, MBBS, PhD, an author of the study. “This
is concerning, because it can lead to serious issues, such as heart
failure and stroke. So even though we do not have randomized
data that tells us what a ‘safe’ amount is to consume, people with
an irregular heartbeat should probably drink no more than one
alcoholic drink per day with two alcohol free days a week.” ■
Voskoboinik A, Prabhu S, Ling L, et al. J Am Coll Cardiol. 2016;68(23):2567-76.