Familial combined hyperlipidemia

Definition

Familial combined hyperlipidemia is a disorder of high cholesterol and high blood triglycerides that is passed down through families.

Alternative Names

Causes

Familial combined hyperlipidemia is the most common disorder of increased blood fats that causes early heart attacks. It is genetic, which means it is caused by a problem with your genes. However, researcher have yet not identified the specific genes responsible.

Diabetes, alcoholism, and hypothyroidism make the condition worse. Risk factors include a family history of high cholesterol and early coronary artery disease.

Symptoms

Persons with this condition develop high cholesterol or triglyceride levels during the teenage years. The levels remain high throughout life. They have an increased risk of early coronary artery disease and therefore, heart attacks. Persons with familial combined hyperlipidemia have a higher rate of obesity and glucose intolerance.

Chest pain (angina) may occur. However, there may not be any physical symptoms.

Exams and Tests

Blood tests will be done to check your levels of cholesterol and triglycerides. Specific tests include:

• Serum LDL
• Serum HDL cholesterol
• Triglycerides
• Apolipoprotein B100 test

Genetic testing is available for one type of familial combined hyperlipidemia.

Treatment

The goal of treatment is to reduce the risk of atherosclerotic heart disease.

The first step is to change what you eat. This is tried for several months before drug therapy is added. Diet changes include reducing total fat intake to less than 30% of the total calories consumed. Saturated fat intake is reduced by decreasing the amounts of beef, chicken, pork, and lamb; by substituting low-fat dairy products for full-fat ones; and by eliminating coconut and palm oil. Cholesterol intake is reduced by eliminating egg yolks and organ meats.

Further reductions in dietary fat may be recommended after the initial trial period. Dietary counseling is often recommended to help people make these adjustments to their eating habits. Weight loss and regular exercise may also aid in lowering cholesterol levels.

Your doctor may recommend medicine if diet, exercise, and weight loss efforts have not lowered your cholesterol levels. Cholesterol-lowering medicines include:

• Bile acid-sequestering resins
• Fibrates (such as gemfibrozil)
• Nicotinic acid
• Statins

Outlook (Prognosis)

How well a person does depends on how early the condition is diagnosed, when treatment is received, and whether treatment is followed. Without treatment, heart attack or stroke may cause early death.

Some persons may have such high lipid levels that an increased risk of heart attack remains despite medical therapy.

Possible Complications

• Early atherosclerotic heart disease
• Heart attack
• Stroke

When to Contact a Medical Professional

Call your health care provider if you have warning symptoms of heart attack or your screening total cholesterol or triglycerides are high.

Prevention

A low-cholesterol, low-saturated fat diet in high-risk individuals may help to control LDL levels.

If someone in your family has this condition, you may consider genetic screening yourself or your children. Sometimes younger children may have mild hyperlipidemia

It is important to control other risk factors for early heart attacks, such as smoking, if you have this disease.