Mixed Dyslipidaemia

Key facts

• Mixed dyslipidaemia means LDL cholesterol and triglycerides are both raised, often with low HDL ("good") cholesterol at the same time.
• Insulin resistance is the most common driver: it raises triglyceride production and suppresses HDL. Type 2 diabetes, metabolic syndrome, obesity, heavy alcohol use, and some thyroid conditions can cause or worsen the pattern; family history matters too.
• Because two separate lipid problems are involved, treatment often combines drug classes: fenofibrate targets triglycerides and HDL, while agents such as bempedoic acid target LDL. Both sit within the cholesterol and heart and blood pressure treatment areas.
• This combination carries a higher cardiovascular risk than any single lipid abnormality alone, so it is usually managed as part of overall heart health, not treated in isolation.

What drives the abnormal lipid pattern

Insulin resistance underlies most cases: it pushes the liver to produce more triglycerides while lowering HDL at the same time. Type 2 diabetes, metabolic syndrome, obesity, heavy alcohol use, and certain thyroid conditions can all produce or worsen this pattern. Family history plays a role too. Familial combined hyperlipidaemia is one of the more common inherited causes seen in clinical practice, and it tends to run through generations even when weight and diet are well controlled.

Tackling the full lipid picture

Because mixed dyslipidaemia involves both cholesterol and triglycerides, treatment often goes beyond a single medicine. Fenofibrate suits the triglyceride and HDL component well, while agents that target LDL, such as bempedoic acid, address the cholesterol side. Both belong to the broader cholesterol and heart and blood pressure therapeutic areas, and a doctor will often combine approaches rather than rely on one drug class. Dietary changes, cutting refined carbohydrates, added sugars, and alcohol, produce meaningful improvement alongside any medicine, and regular exercise helps both sides of the lipid picture at once.

When to see a doctor

Persistently high triglycerides, above roughly 10 mmol/L, can trigger pancreatitis. Seek medical attention promptly if you experience sudden, severe abdominal pain. Anyone with a mixed lipid pattern should have periodic blood tests and a cardiovascular risk review, since the combination raises risk more than either abnormality alone.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.