Familial combined hyperlipidemia

How Is It Treated?

The goal of treatment is to reduce the risk of

.

LIFESTYLE CHANGES

The first step is to change what you eat. Most of the time, you will try diet changes for several months before your health care provider recommends medicines. Diet changes include lowering the amount of

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

It may help to talk to a dietitian who can give you advice about

. Weight loss and regular exercise may also help lower your cholesterol level.

MEDICINES

If lifestyle changes do not change your cholesterol levels enough, or you are at very high risk for atherosclerotic heart disease, your provider may recommend that you take medicines. There are several types of medicines to help lower blood cholesterol levels.

The medicines 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 medicines 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).

Other cholesterol-lowering medicines include:

• Bile acid-sequestering resins.
• Ezetimibe.
• Fibrates (such as gemfibrozil and fenofibrate).

• Nicotinic acid

  .

• PCSK9 inhibitors, such as alirocumab (Praluent) and evolocumab (Repatha) These represent a newer class of medicines to treat high cholesterol.

What Is Outlook (Prognosis)?

How well you do depends on:

• How early the condition is diagnosed
• When you start treatment
• How well you follow your treatment plan

Without treatment, heart attack or stroke may cause early death.

Even with medicine, some people may continue to have high lipid levels that increase their risk for heart attack.

What Are Possible Complications?

Complications may include:

• Early atherosclerotic heart disease
• Heart attack
• Stroke

When to Contact a Medical Professional?

Seek medical care right away if you have chest pain or other warning signs of a heart attack.

Contact your provider if you have a personal or family history of high cholesterol levels.

How Is It Prevented?

A diet that is low in cholesterol and saturated fat may help to control LDL levels in people at high risk.

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

.

It is important to control other risk factors for early heart attacks, such as smoking.