Genetics can play a role in cholesterol levels and can be inherited. Familial hypercholesterolemia is an inherited condition that increases the risk of heart disease at an early age. If a close relative has high cholesterol, you're more likely to have it yourself. Mutations of the LDLR gene can change the way receptors develop, either in number or structure. Other genetic factors such as obesity, BMI, and family history may also contribute to high cholesterol levels.