Sunday 17 / November / 2024
Many people start their stories with, "Heart disease and stroke run in my family." But "runs in the family" is not a diagnosis. Genetic cholesterol disorders are often the hidden cause of early heart attack and stroke.
Like many men in their 20s, Chad Gradney led a healthy, active lifestyle as a father and husband. So, it was a surprise when he woke up one morning at the age of 27 with severe chest pain. He had multiple doctors visits dismissing his pain as acid reflux and even asthma. One day the pain was too much to bear and he went to the emergency room and soon was having emergency, open-heart, quadruple bypass surgery.
Gradney didn't know there was a silent, undetected cause for his premature heart disease. Gradney recovered from surgery and tried to move on. Unfortunately, a few years later he was back in the ER with more blockages in his heart.
Gradney and his wife decided to visit a specialist who finally determined the underlying causes for his early heart disease: a common, life-threatening genetic condition known as familial hypercholesterolemia (FH). FH leads to very high levels of low-density lipoprotein cholesterol (LDL-C), also known as "the bad cholesterol." Years later, Gradney also learned he has high Lipoprotein(a), or Lp(a), another genetic, cardiovascular risk factor.
This was devastating news, but the Gradneys were grateful to have a diagnosis.
FH and high Lp(a) increased Gradney's risk for heart disease, but as a Black American person, the risk increased even higher. According to research from the Family Heart Foundation, Black persons with FH are less likely to be prescribed cholesterol-lowering treatments beyond statins. While statins are crucial in lowering cholesterol, those with FH typically need 3-5 medications to get to safe LDL-C levels. Black Americans also experience significantly higher Lp(a) levels, as compared to White persons.
"We were easily dismissed because Chad looked young and was healthy, so we had to advocate for ourselves in order to find answers," said Gradney's wife. "We found the Family Heart Foundation to be a good resource to get the answers we needed."
Gradney has since received appropriate treatment. He combines several medications to lower his LDL cholesterol to recommended levels. Gradney also follows a heart-healthy lifestyle. Because FH and high Lp(a) are genetic disorders, the Gradneys decided to follow the American Academy of Pediatrics recommendation to have their children's cholesterol tested at age 2. Chad also has two brothers, who despite knowing the history and sharing with healthcare providers, both had quadruple bypass surgery before the age of 45.
"I wish we knew that FH and high Lp(a) ran in our family when my father was alive so we could have had a chance to prevent early heart disease in my generation," said Gradney. "Now that we know more, we can try to end heart disease in our family's future generations."
According to the Family Heart Foundation, most individuals born with FH or high Lp(a) do not know they are at risk for early heart disease or stroke. These conditions usually don't have symptoms. In fact, their first sign may be a heart attack.
"The good news is genetic cholesterol disorders are not difficult to diagnose. The combination of elevated LDL-C or Lp(a), a family history of early cardiovascular disease, and a good physical exam can make the diagnosis. FH occurs in 1 in 250 individuals and elevated Lp(a) occurs in 1 in 5. Health care providers need to keep this in mind when treating their patients," said Dr. Mary McGowan, chief medical officer at the Family Heart Foundation. "With early, consistent, and aggressive treatment, individuals with these conditions can live longer, healthier lives." Medications to lower Lp(a) are currently in clinical trials.
Like many others battling FH and elevated Lp(a), Gradney's story brings hope to people with increased risk of early heart disease.
