Genetic High Cholesterol Higher in Lewiston-Auburn, Maine
25
August

By Adem Lewis / in , , , , , , , , , , , , /


(light music) – Hello, my name is Dr. Dervilla McCann. I’m a cardiologist and
chief of population health at Central Maine Medical
Center in Lewiston, Maine. When I began practicing
cardiology here years ago, I began seeing patients with heart attacks at a very young age, and I learned that my patients
had a condition called familial hypercholesterolemia,
or FH for short. Although FH is found in
every country in the world and every ethnic group, certain groups have this disorder more frequently than others. One such group is Franco-Americans, who are descended from the
original founders of Quebec. To understand the story of why Franco-Americans in particular are affected by this disorder
more than other groups, you’ll need to understand
the story that links together geography, history, public
health, and genetics. The great rivers of New England. These great arteries
have served as a source of food and water,
transportation, and power, shaping the history of
the people of the region. Water power from these rivers
was the natural resource that centered the textile manufacturing of the US Industrial
Revolution in New England. Throughout the 1800s, mills sprang to life from Maine to Connecticut, and the need for skilled laborers grew. Many workers for the factories
and mills of New England came from America’s
northern neighbor, Canada. In particular, the French Canadians, who were descendants of the
original founders of Quebec, were drawn to the work
in the textile mills of the northeastern states, where they were offered high wages and predictable employment. In the 1850s, a wave of
immigration to America began, eventually leading to more than 200,000 French Canadians leaving Canada. River travel made way to a railroad system from Quebec through New England. Several enterprising
businessmen raised money to build a short addition
to the railroad system, enabling the immigrants
to end their journey close to the mills, like
this one in Lewiston, Maine, where a small rail depot sits just next to the large Bates Textile Mill. This was one of the very first stops on the way south from Quebec, and thousands disembarked here, staying in this region of central Maine for the remainder of their lives. A particularly strong
Franco-American presence was established in the New England region, and persists to this day. Often, one family
member, such as a father, would begin work, and
then send for his family, who were also able to work at the mills. Child labor was considered a necessity, particularly in the weaving of cotton, where any break in the thread would shut down the weaving machine. The broken threads had to be hand-tied in order for the work to start again, and the smaller hands
of women and children were better suited to this task. In 1900, the average
life expectancy in the US was only 46 years for
men, and 48 for women. Over the next 100 years, due in large part to public health improvements and an understanding of
the cause of infections, life expectancy became much longer. During that period, it became more evident that culture was not the
only thing handed down to the new generations. As the general population lived longer, it became obvious that
the Franco-Americans had a high rate of heart attacks, often at an early age. It was not until the late 1900s, however, that the reason for this was revealed. It was found in a gene that caused high cholesterol levels. Many Franco-Americans have this form of genetic heart disease, called familial hypercholesterolemia,
or FH for short. Cholesterol is a building block for many important body functions. The molecule circulates
in the blood stream and it goes throughout the body. But when it is present in too high levels, it can become embedded in
the walls of the arteries, causing thickening and blockages. This is the cause of most
heart attacks and strokes. Cholesterol is produced by the liver and recycled there too. Ordinarily, there are receptors on the surface of the liver cell that attach to the LDL cholesterol, allowing it to be taken up
by the liver and recycled. But in FH, that process is disrupted, and the damaging LDL cholesterol accumulates in the blood vessels. Unfortunately, only about
10% of people with FH are diagnosed with this disorder. This film was made to
assist those patients understanding their disorder, and to encourage
physicians who see patients with high cholesterol to
test their family members, and to consider FH as a diagnosis. There are now a range
of therapeutic options for patients who have FH, and I encourage you to discuss
those with your physician.


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