Chest pain (angina) or other signs of coronary artery disease; may be present at a young age
Cramping of one or both calves when walking
Sores on the toes that do not heal
Sudden stroke-like symptoms, such as trouble speaking, drooping on one side of the face, weakness of an arm or leg, and loss of balance
People with this condition may develop high cholesterol or high triglyceride levels as teenagers, or the condition may be diagnosed when people are in their 20s and 30s. The levels remain high all during life. Those with familial combined hyperlipidemia have an increased risk of early coronary artery disease and heart attacks. They also have higher rates of obesity and are more likely to have glucose intolerance.
Exams and Tests
Blood tests will be done to check your levels of cholesterol and triglycerides. Tests will show:
The first step is to change what you eat. Most of the time, you will try diet changes for several months before your doctor recommends medicines. Diet changes include lowering the amount of saturated fat and refined sugar.
Here are some changes you can make:
Eat less beef, chicken, pork, and lamb
Substitute low-fat dairy products for full-fat ones
Avoid packaged cookies and baked goods that contain trans fats
Reduce the cholesterol you eat by limiting egg yolks and organ meats
If lifestyle changes do not change your cholesterol levels, or you are at very high risk for atherosclerotic heart disease, your doctor may recommend that you take medicines. There are several types of drugs to help lower blood cholesterol levels.
The drugs work in different ways to help you achieve healthy lipid levels. Some are better at lowering LDL cholesterol, some are good at lowering triglycerides, while others help raise HDL cholesterol.
The most commonly used, and most effective drugs for treating high LDL cholesterol are called statins. They include lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), fluvastatin (Lescol), atorvastatin (Lipitor), rosuvastatin (Crestor), and pitivastatin (Livalo).
Larry A. Weinrauch MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.