Hypertriglyceridemia and cardiovascular risk reduction

Clin Ther. 2007 May;29(5):763-777. doi: 10.1016/j.clinthera.2007.05.002.

Abstract

Background: Elevated triglyceride (TG) levels are prevalent among the US population, often occurring in persons who are overweight or obese, or who have type 2 diabetes or the metabolic syndrome. There is evidence that elevated TG levels may be a significant independent risk factor for coronary heart disease (CHD), particularly in women.

Objective: This article reviews data on the epidemiology, associated risks, treatment, and prevention of hypertriglyceridemia, including recommended TG goals and available TG-lowering agents.

Methods: MEDLINE was searched for articles published from 1990 through 2006 using the terms hypertriglyceridemia, dyslipidemia, and coronary heart disease, with subheadings for risk, statins, niacin, fibrates, thiazolidinediones, and omega-3 fatty acids. The reference lists of relevant articles were examined for additional citations. Publications discussing the epidemiology of hypertriglyceridemia, CHD risk, treatment guidelines for lipid management, clinical trials involving TG-lowering drugs, and outcomes for lipid-modifying therapies were selected for review.

Results: Concern over the increasing rate of hypertriglyceridemia and its deleterious health consequences is reflected in the most recent National Cholesterol Education Program guidelines. Several lipid-lowering agents are available, including statins, fibrates, niacin, thiazolidinediones, and prescription omega-3 fatty acids. Clinical trials of these drugs have reported lowering of TG by 7% to 50%. Along with lifestyle changes, the use of combination pharmacotherapy to reduce lipid levels (including TG) may be an effective strategy in patients with dyslipidemia.

Conclusion: Use of strategies to manage TG levels, along with low-density lipoprotein cholesterol levels, is warranted to help reduce the risk of CHD.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Atherosclerosis / etiology
  • Atherosclerosis / prevention & control
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Clofibric Acid / therapeutic use
  • Coronary Disease / etiology
  • Coronary Disease / prevention & control
  • Fatty Acids, Omega-3 / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypertriglyceridemia / complications
  • Hypertriglyceridemia / epidemiology
  • Hypertriglyceridemia / therapy*
  • Hypolipidemic Agents / therapeutic use
  • Niacin / therapeutic use
  • Risk Reduction Behavior
  • Thiazolidinediones / therapeutic use

Substances

  • Fatty Acids, Omega-3
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypolipidemic Agents
  • Thiazolidinediones
  • Niacin
  • Clofibric Acid