About the campaign
Familial Hypercholesterolemia (FH) awareness day is on 24 September. This year in Somerset we are trying to find some of the estimated 2000 people in Somerset who may have FH (or similar genetic conditions) so they and their families can be treated.
Each diagnosis can lead to protection for a whole family! You can help us by spreading the message.
Heart attack under 60 in your family?
Get a free NHS Health Check
If you are aged 40 to 74 and do not have any diagnosis of heart disease, then there is an NHS Health Check waiting for you. This will include a finger prick test of your cholesterol levels and may quickly be able to put your mind at rest or give you and your GP more knowledge of what to do next.
- For Somerset residents or those registered with a Somerset GP, book an NHS Health Check in Somerset.
- If you are outside of Somerset, then google NHS Health Check in your local area.
Assess your family history
If you do have a family history of heart attacks in your family, the genetic closeness of your family member makes a difference to what you need to do next.
DO contact your GP if:
- You have a full sibling, parent or child, with a heart attack which happened when the person was aged under 60. This is a first degree relative and you share half your DNA with this person so there is a high chance you share the same risks.
- You have a half-sibling, a parent’s full sibling (blood Aunt or Uncle) or your grandparent who had a heart attack which happened when the person was aged under 50. This is a second degree relative you share a quarter of DNA. Although your genetic similarity is less, this is a strong risk which needs checking out.
Don’t contact your GP only based on:
- A full sibling, parent or child, or other first degree relative with a heart attack history aged 60 or above. Heart disease is more common after this age and you should look after yourself, but it is not a strong signal of a genetic condition.
- Half-sibling, a parent’s full sibling (blood Aunt or Uncle) or your grandparent with a heart attack history, which happened when that person was aged 50 to 60 or above. This is not a strong risk for you but please alert your relative if the heart attack was aged 50 to 59.
- Third degree or more distant relatives with a heart attack history below aged 60, such as a cousin or great uncle, great grandparent.
- Relatives by adoption or marriage with a heart attack history below aged 60, such as step-parent, adoptive sibling, aunt or uncle by marriage, in-laws.
- Relatives with other cardiovascular diseases like diabetes below age 60.
If you have a mix of family history in the do and don’t list then DO contact your GP and tell them who in your family has had a heart attack and at what age. If you know of people in your family with high cholesterol then add that in too. You may wish to add further information on any recent cholesterol tests you have had or other signs you notice but please let them know even if you feel these are normal.
Pass the message on if you know someone like this.
How to let your GP know?
You don’t need to phone your GP practice, it is probably easier if you use a contact form on the practice website, a triage form (often only available in the morning) or drop in a letter including your contact details.
You can adapt the messages below if it helps.
“I would like to let you know of my family history of heart attack below age 60 in blood relatives to assess my risk of familial hypercholesterolaemia. My father had a heart attack at age 56, my mother’s brother had a heart attack at age 48. I have not had a recent cholesterol test.”
“I’ve seen the recent FH campaign. I would like to let you know of my family history of heart attack below age 60 in blood relatives. First degree relatives: My brother had a heart attack at age 48, my mother had a first heart attack at age 59. Second degree relatives: my father’s brother had a first heart attack in his forties. I’ve just had an NHS Health Check a few weeks ago so may have a recent result in the system. Could you please advise on next steps to assess my risk of FH?”
Free NHS Health Checks
People can still be at risk of high cholesterol, even without a genetic condition. If you are aged 40 to 74 we recommend you book a free NHS Health Check once every five years. This will include a finger prick assessment of your cholesterol. This is an opportunity to find out your cholesterol levels and what you can do to protect your health.
What to do about high cholesterol
What is cholesterol?
Cholesterol is a type of fat in the blood. We can get some of our cholesterol from our diet, but it is mainly produced in the liver.
Cholesterol can be split into LDL cholesterol and HDL cholesterol.
- LDL cholesterol (sometimes known as “bad” cholesterol) – can build up in the arteries and increase the risk of heart attacks and stroke.
- HDL cholesterol – carries excess cholesterol away to be broken down
Anyone can have a high cholesterol level, meaning controlling these levels is important for reducing these risks.
Understanding Your Cholesterol
To find out more watch this Understanding Your Cholesterol Video from HEART UK
Anyone can have high cholesterol; here are some things you can do to look after yourself.
Simple steps to lower your cholesterol
Drink less Alcohol
Heavy drinking consistently increases bad cholesterol. Try to have fewer drinks with alcohol. Learn more on from our Alcohol and substance use page.
Smoke less
Smoking stops good cholesterol from doing its job. Stopping smoking can improve cholesterol levels. Find out more on our Tobacco, smoking and vaping page.
Healthy eating
Foods high in saturated fat and sugar, such as processed meats or cakes, can cause high cholesterol. Swap these for foods high in unsaturated fats, like nuts or oily fish. You can learn more on our Healthy eating page.
Keep active
Being active strengthens your heart and reduces bad cholesterol. Look for chances to move more every day, like taking the stairs or going for a walk. Read more on our Getting Active and Moving more page.
If you have FH or other inherited high cholesterol levels then even with these steps you may need medication to help lower your cholesterol levels. Your GP may refer you to a specialist clinic for review.
What happens if you have been referred to a specialist clinic?
Agnes, explains next steps if you have been referred to a specialist clinic for review.
The aim of the Familial Hypercholesterolemia (FH) clinic is not simply to find a genetic change. It is to identify FH early, help you understand your condition, support you with appropriate cholesterol treatment, and help protect the health of you and your family for the future.
If you have any questions about FH, genetic testing or testing other family members, please ask. We are here to support you throughout the process.
What happens at the FH clinic?
As an FH Clinical Nurse Specialist, I run a clinic for people who may have familial hypercholesterolaemia (FH). FH is an inherited condition that can cause high cholesterol from an early age and can increase the risk of heart and blood vessel disease.
If you have been referred because your cholesterol levels or your family history suggest that you may have FH, we will talk you through what this means and what happens next.
Assessing for FH and genetic testing
During your appointment, we will talk about your cholesterol levels, your medical history, and your family history. This helps to understand whether FH may be present in your family.
Where appropriate, we will discuss genetic testing with you. Genetic testing looks for changes (mutations) in specific genes known to cause FH. We will explain what the test involves, what the possible results mean, and answer any questions you may have before you decide whether you would like to go ahead (provide consent).
Understanding your results
Once your genetic test result is available, we will discuss the result with you and explain what it means for you and your family.
If the test confirms that you have a genetic change associated with FH, we will talk about how best to manage your cholesterol and reduce your risk of heart and blood vessel disease. This may include discussing cholesterol-lowering treatment, lifestyle changes and the cholesterol levels target we would aim to achieve to help protect your heart and blood vessels.
We will make sure you understand your treatment options and ask questions, so that you can feel informed and involved in decisions about your care.
Why testing your family is so important
Because FH is inherited, other members of your family may also have FH. This is why we strongly recommend what is known as cascade testing.
Cascade testing means offering testing to first degree relatives of someone who has been found to have FH. Identifying FH early means that family members can receive the right advice, treatment and monitoring to help reduce their future risk of heart disease.
If your genetic test confirms FH, we can provide you with information and letters that you can share with your blood relatives. These explain that FH may run in the family and invite them to self-refer for testing.
You do not have to have these conversations with your family alone. We can provide information to help you explain what FH means and why it is important for relatives to be tested.
Living with Familial Hypercholesterolemia (FH)
A common inherited condition affecting how the body processes cholesterol. This makes it harder for LDL cholesterol to be taken out of you blood quickly and easily, meaning it can build up in the arteries.
It affects about 1 in every 250 people. Around 2000 people in Somerset have FH but don’t know it yet. Finding out your cholesterol levels can help you get the correct support to keep you healthy.
You are not alone
There are about 100 people diagnosed with Familial Hypercholesterolaemia in Somerset. We estimate there are probably around 2000 people in Somerset who have the condition and are not yet diagnosed.
