Combined dyslipidemia, characterized by the elevation of low-density lipoprotein-cholesterol (LDL-C), triglycerides (TG) a decrease of high-density lipoprotein-cholesterol (HDL-C) is associated with increased cardiovascular risk. An increased prevalence of mixed dyslipidemia is due to the frequent appearance of risk factors such as obesity, diabetes mellitus or insulin resistence, metabolic syndrome or physical inactivity.
The weight management and physical activity are the cornerstones in the therapy of the combined dyslipidemia. The pharmacotherapy of lipid triad should often use a combined hypolipidemic treatment.
The combination of hypolipidemic drugs is indicated when the treatment goal (NCEP III, ATP III) is not accomplished. There are the following possible combinations: fibrate + statin, fibrate + niacin, fibrate + ezetimibe, statin + niacin or + ezetimibe.