What Is Mixed Hyperlipidemia?

Hyperlipidemia (also called multiple lipoprotein-type hyperlipidemia) is a genetic disorder in which a combination of high cholesterol and high triglycerides is inherited and passed down from family members. This is one of the most common contributors to early heart attacks. The condition may be worsened by other disorders, like hypothyroidism, diabetes and alcoholism.


Many patients with mixed hyperlipidemia are asymptomatic (have no symptoms). Others do experience symptoms, including: chest pain (angina); xanthoma (a condition in which fat builds up under the skin’s surface); xanthelasma of the eyelid (which is the same as a xanthoma, but is located on the eyelid); pain in the abdomen; spleen enlargement; and enlarged liver. Patients with mixed hyperlipidemia are at a higher risk of developing early coronary artery disease and heart attacks, and also have an increased rate of glucose intolerance and obesity.


One type of condition may be identified with genetic testing. Otherwise, blood tests are the primary means of diagnosing mixed hyperlipidemia. The specific tests that your doctor will run include checking the levels of :LDL (low-density lipoprotein (too much of which clogs arteries); HDL (high-density lipoprotein, which helps move fats, cholesterol and triglycerides throughout the body. Higher levels are linked to lower risk of coronary artery disease); triglycerides (produced in the body, they also come from foods. Unburned calories turn into triglycerides and are stored in fat cells); and apolipoprotein B100 (this test measures a specific protein that plays a key role in metabolism and is type of LDL).


The goal of any treatment for mixed hyperlipidemia is to reduce the risk of complications and heart disease. Often, the first step will be to make dietary changes, like reducing total fat intake to less than 30 percent of daily calories, decreasing meats and high-fat dairy products, and eliminating egg yolks and organ meats. Exercise will often be recommended in combination with diet to help lower dangerous levels. If diet and exercise do not lower your cholesterol levels, your doctor may prescribe medication like statin drugs, nicotinic acid, omega-3 acids (which help to lower triglyceride levels) or fibrates.


Individual results will vary based on how early you are diagnosed and how well you follow and respond to treatment. Your doctor will determine the best course of treatment for your individual situation. Some individuals with very high levels are still susceptible to complications, even with medical intervention. If left untreated, the mixed hyperlipidemia can lead to stroke, heart attack or atherosclerotic heart disease--all of which can lead to an early death.


If you know that you have a family history of this condition, genetic screening may identify the disease at early stages (where it is likely to be more receptive to dietary therapy). Following a diet low in saturated fat and cholesterol can help to manage LDL levels in high-risk patients. If you have other risk factors for heart disease/heart attack (like smoking or obesity), it is important to try to control those additional factors to minimize the risk of an early heart attack or death.