Familial Combined Hyperlipidemia
What is Familial Combined Hyperlipidemia?
Familial combined hyperlipidemia is a genetic condition that causes your body to produce too much cholesterol and triglycerides. It is one of the most common inherited lipid disorders, affecting about 1 in 100 people. When you have this condition, your liver makes excess fats that build up in your bloodstream.
Unlike other genetic cholesterol conditions, familial combined hyperlipidemia can show up differently even within the same family. Some people have mostly high LDL cholesterol, while others have high triglycerides or both. Many people also have low HDL cholesterol, the protective kind that helps remove excess fats from your blood.
This condition typically appears in early adulthood, often in your 20s or 30s. Because it runs in families, multiple relatives across generations may be affected. The elevated lipid levels significantly increase your risk of heart disease and stroke if left untreated.
Symptoms
- Most people have no symptoms in the early stages
- Fatty deposits around the eyes or on tendons
- Chest pain or pressure from heart disease
- Abdominal pain from pancreatitis when triglycerides are very high
- Yellowish bumps on skin called xanthomas
- Early heart attacks, sometimes before age 50
- Family history of high cholesterol or early heart disease
Many people with familial combined hyperlipidemia feel completely healthy despite dangerous lipid levels. This is why testing your blood is the only reliable way to catch this condition early.
Concerned about Familial Combined Hyperlipidemia? Check your levels.
Screen for 1,200+ health conditions
Causes and risk factors
Familial combined hyperlipidemia is caused by genetic variations that affect how your liver processes fats. Multiple genes are involved, which explains why the condition shows up differently in different people. If one parent has the condition, each child has a 50% chance of inheriting it. The genetic changes cause your liver to overproduce fats or fail to clear them properly from your blood.
Lifestyle factors can make the condition worse even though genes cause it. Being overweight, eating too much saturated fat or refined carbs, and physical inactivity all worsen lipid levels. Diabetes, hypothyroidism, and certain medications can also raise your triglycerides and cholesterol further. Smoking increases cardiovascular risk in people who already have elevated lipids.
How it's diagnosed
Familial combined hyperlipidemia is diagnosed through blood testing that measures your cholesterol and triglycerides. Your doctor will look at total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and VLDL cholesterol levels. Advanced testing can also measure LDL particle number, LDL pattern, and LDL small particle size to understand your risk better.
Rite Aid offers testing for all the biomarkers needed to detect and monitor familial combined hyperlipidemia. Our flagship panel includes over 200 biomarkers measured twice per year. Your doctor will also ask about family history, especially if relatives had high cholesterol or heart attacks before age 55 in men or 65 in women.
Treatment options
- Adopt a heart-healthy diet low in saturated fats and refined sugars
- Increase physical activity to at least 150 minutes of moderate exercise weekly
- Lose weight if overweight, as even 5 to 10% weight loss helps
- Quit smoking to reduce cardiovascular risk
- Limit alcohol, which can raise triglycerides significantly
- Statins like atorvastatin or rosuvastatin to lower LDL cholesterol
- Fibrates such as fenofibrate to reduce triglycerides
- Omega-3 fatty acids for high triglycerides
- Niacin to raise HDL and lower triglycerides in some cases
- PCSK9 inhibitors for very high LDL that does not respond to statins
Concerned about Familial Combined Hyperlipidemia? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
Familial combined hyperlipidemia is a genetic disorder that causes your liver to produce too much cholesterol and triglycerides. It is one of the most common inherited lipid conditions, affecting about 1 in 100 people. The condition runs in families and increases your risk of heart disease if not treated.
Most people have no symptoms until complications develop. The only way to know is through blood testing that measures cholesterol and triglycerides. A family history of high cholesterol or early heart disease is a strong clue that you should get tested.
Diagnosis requires measuring total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and VLDL cholesterol. Advanced testing may include LDL particle number, LDL pattern, and small LDL particles. These tests together show the specific lipid abnormalities present.
Lifestyle changes are essential but usually not enough on their own because this is a genetic condition. Eating a heart-healthy diet, exercising regularly, and losing weight all help lower lipid levels. Most people also need medication to reach safe cholesterol and triglyceride targets.
Statins like atorvastatin are the first choice for lowering LDL cholesterol. Fibrates such as fenofibrate help reduce triglycerides. Some people need both types of medication, plus omega-3 fatty acids or other drugs to control multiple lipid abnormalities.
No, they are different genetic conditions. Familial hypercholesterolemia mainly causes very high LDL cholesterol. Familial combined hyperlipidemia can cause high LDL, high triglycerides, or both, and often causes low HDL cholesterol too.
If you have the condition, each of your children has a 50% chance of inheriting it. Because multiple genes are involved, the severity can vary widely even within the same family. All children of affected parents should have their lipid levels checked.
After diagnosis, you should get tested every 3 to 6 months until your lipid levels are well controlled. Once stable on treatment, testing every 6 months is usually recommended. Regular monitoring helps ensure your treatment is working and prevents complications.
Yes, this condition significantly increases your risk of heart attack and stroke. The elevated cholesterol and triglycerides cause fatty plaques to build up in your arteries. With proper treatment and lifestyle changes, you can reduce this risk substantially.
Focus on whole foods including vegetables, fruits, whole grains, lean proteins, and healthy fats like olive oil. Limit saturated fats from red meat and full-fat dairy. Avoid refined sugars and carbs that raise triglycerides, and reduce alcohol intake.