Incidence increasing along with number of patients who are overweight or obese.
Associated with increased cardiovascular risk.
May cause acute pancreatitis when fasting levels >500 mg/dL.
Treatment includes lifestyle modification for all patients.
Statins are generally first-line pharmacotherapy in patients with triglycerides <500 mg/dL in the presence of ≥2 cardiac risk factors.
Fibric acid derivatives or fish oils are used as first-line therapy in those with triglycerides <500 mg/dL. They may be added to statins to achieve targets in patients with triglycerides <500 mg/dL.
Hypertriglyceridemia is defined by the National Cholesterol Education Program Adult Treatment Panel III as fasting plasma triglyceride level ≥200 mg/dL. Borderline high is defined as 150 to 199 mg/dL, high as 200 to 499 mg/dL, and very high as ≥500 mg/dL. Chylomicronemia is present when a triglyceride level is ≥1000 mg/dL. Guidelines from several national and international medical organizations regarding the determination and treatment of hypertriglyceridemia use different nomenclature, yet are similar in their recommendations.
History and exam
- family history of hyperlipidemia
- family history of diabetes
- overweight/obese patients
- high-saturated-fat diet
- high-carbohydrate diet
- insulin resistance
- liver disease
- renal disease
- excessive alcohol consumption
- HIV infection
- cystic fibrosis
- Cushing syndrome
- acute spinal cord injury
- inflammatory/immune disorders
- anorexia nervosa
- organ transplant
David Alexander Leaf, MD, MPH
Professor of Medicine
Playa Vista Medical Center
DAL is an author of several references cited in this monograph.
Mahi Lakshmi Ashwath, MD
Assistant Professor of Medicine
Division of Cardiology
Heart and Vascular Center
Metro Health Medical Center
Case Western Reserve University
MLA declares that he has no competing interests.
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