Mixed hyperlipidemia, also called familial combined hyperlipidemia, is a condition that causes high levels of fats in the blood, such as low-density lipoprotein (LDL) cholesterol ( "bad" cholesterol) and triglycerides .
Mixed hyperlipidemia can be inherited. However, it can also be idiopathic (of unknown cause) or the result of other conditions such as liver disease, kidney disease, and thyroid disease. Mixed hyperlipidemia can increase the risk of heart disease and lead to problems like heart attacks.
Cholesterol is not always bad, it is a fatty substance that your body needs to make certain hormones and other important compounds that make up cells. There are several types of cholesterol, lipids, and fats in your body, the most common of which are triglycerides.
Even if your body needs these substances, there is a catch. Your body does everything it needs to do, and your diet choices can increase the amount of these substances in your blood to unhealthy levels.
Mixed hyperlipidemia symptoms.
People with mixed hyperlipidemia during adolescence can develop high levels of cholesterol or triglycerides. The condition can also be diagnosed when people are in their 20s and 30s. Levels remain high throughout life.
In the early years, people with this condition may have no symptoms. When symptoms appear, they can include:
- Chest pain
- Cramps in one or both calves when walking
- Toe sores that don't heal
- Sudden stroke-like symptoms, such as speech problems, drooping on one side of the face, weakness in an arm or leg, and loss of balance.
Several genes and genetic mutations have been associated with mixed hyperlipidemia, but the exact cause or mutation is not yet clear. More recent research has shown that there may be misunderstandings between the genes that regulate cholesterol, especially in what is known as Wnt-LRP6 coreceptor signaling.
Additional risk factors
Studies have shown that mixed hyperlipidemia is more common in people with the following conditions:
- Obesity (being overweight)
- Insulin resistance (when muscles, fat, and liver cells do not respond well to the hormone insulin)
- Type 2 diabetes (a disturbance in the way the body uses sugar for fuel)
- Hypertension (high blood pressure)
- Nonalcoholic fatty liver disease (liver disease not caused by excessive alcohol consumption)
- Metabolic syndrome (a group of conditions that can lead to heart disease, stroke, or type 2 diabetes)
- Hypothyroidism (underactive thyroid gland)
Mixed hyperlipidemia is diagnosed primarily through blood tests and physical examination. A lipid panel and other blood tests will measure your blood cholesterol levels. The tests are done on a small sample of blood taken from one of your veins. The sample is usually collected in the morning after at least 12 hours of fasting.
Hyperlipidemia is diagnosed if your blood tests show:
The normal ranges for each of these substances are:
- HDL cholesterol: 40-50 milligrams per deciliter or more.
- LDL cholesterol: less than 100 milligrams per deciliter
- Triglycerides: less than 150 milligrams per deciliter
- Total cholesterol: 125-200 milligrams per deciliter.
Mixed hyperlipidemia test
Mixed hyperlipidemia can be missed without a careful family history and additional testing. The tests can tell you if you have elevated levels of a certain LDL cholesterol protein called apolipoprotein B100. This protein is responsible for moving cholesterol through your body. A high level may indicate mixed hyperlipidemia.
Mixed hyperlipidemia is generally treated in the same way as non-genetic forms of hyperlipidemia. In most cases, this means a combination of lifestyle changes and medication. The goal of treatment is to prevent the progression of the disease to atherosclerosis, the accumulation of fats, cholesterol and other substances in the walls of the arteries.
Changes in lifestyle
Making changes to your diet is often the first step your healthcare provider will take to lower your cholesterol levels. You will need to try to change your diet for several months before your doctor recommends medication.
Lifestyle changes that can prevent mixed hyperlipidemia include:
- Reduce your intake of foods that are high in saturated fat and sugar.
- Eat less beef, chicken, pork, and lamb
- Choosing low-fat dairy products
- Limit the amount of egg yolks and organ meats like liver you eat.
- Choose fresh fruits and vegetables
- Avoid packaged cookies and baked goods that contain trans fat.
- Mevacor (lovastatin)
- Pravachol (pravastatin)
- Zokor (simvastatin)
- Lescol (fluvastatin)
- Lipitor (atorvastatin)
- Crestor (rosuvastatin)
- Livalo (pitavastatin)
Other medications that can help lower cholesterol levels further may also be prescribed, including:
Early recognition and healthy lifestyle changes can help prevent the progression of mixed hyperlipidemia to atherosclerosis.
Your overall prediction will depend on:
- How soon will it be diagnosed?
- When you start treatment and make any necessary lifestyle changes
- How well are you sticking to your treatment plan?
Complications of mixed hyperlipidemia occur when high blood cholesterol levels begin to build up in the arteries and impair blood flow.
Atherosclerosis and other vascular diseases caused by high cholesterol levels increase the risk of heart attack and stroke.
Mixed hyperlipidemia is a condition characterized by high cholesterol levels. Symptoms generally do not appear earlier or later in life. When symptoms do occur, you will need medications and lifestyle changes to control your cholesterol levels and prevent complications such as heart disease and stroke. With proper intervention, people can keep this condition under control.
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There are many things that can cause high blood cholesterol, some of which you can control, such as your diet choices. However, high cholesterol levels can sometimes be caused by genetic mutations passed down from parent to child or by a complication of other diseases.
If you have mixed hyperlipidemia, you can still choose a diet that helps lower your cholesterol levels. You may also need medicine. The goal is to prevent plaque formation, which can lead to atherosclerosis and ultimately a heart attack or stroke.
Be sure to talk with your doctor not only about your personal lifestyle and medical history, but also about your family medical history. Detected early and treated, this disease can minimize its impact on your life.
Frequently asked questions
Symptoms of mixed hyperlipidemia are usually absent at a young age. Symptoms can occur as the condition progresses and can include chest pain, leg cramps, sores that do not heal, and stroke-like symptoms. As complications develop, such as a heart attack, you may also experience other symptoms.
Genetic mutations passed from parent to child can cause mixed hyperlipidemia. Researchers are still trying to find out which genes and mutations are involved. It can also be idiopathic (meaning the cause is unknown) or is associated with other conditions, such as liver, kidney, and thyroid disease. Diet and other lifestyle choices can also help.
Since mixed hyperlipidemia shows no symptoms in the first few years of life, lipid paneling and genetic testing are ways your doctor can determine if you have high cholesterol and what is causing it.
Avoid foods high in saturated and trans fats, added sugars, and prepackaged foods. It also helps limit your intake of meat, egg yolks, and organ meats, which are high in cholesterol. When possible, choose whole foods, such as fruits and vegetables, rather than processed foods.
Lifestyle changes are the best first step in treating mixed hyperlipidemia. Medications such as statins may also be prescribed, which can help lower your cholesterol levels.