Current perspectives on the management of hypertriglyceridemia

Area of Science:

• Cardiovascular Medicine
• Lipid Metabolism
• Preventive Cardiology

Background:

• Triglycerides are an independent risk factor for coronary heart disease.
• Atherothrombosis may involve triglyceride-rich lipoproteins and altered LDL/HDL particles.
• While lowering LDL cholesterol reduces cardiovascular events, the role of triglyceride lowering is unclear.

Purpose of the Study:

• To review evidence on triglyceride lowering strategies for cardiovascular disease prevention.
• To assess the independent benefit of triglyceride reduction on coronary event rates.

Main Methods:

• Review of major arteriographic and clinical end point trials.
• Evaluation of dietary, hygienic, and pharmacologic interventions for triglyceride management.

Main Results:

• Dietary changes and aerobic activity can reduce triglycerides by 20-24%.
• Omega-3 fatty acids, nicotinic acid, fibrates, and statins effectively lower triglyceride levels.
• No independent benefit of triglyceride lowering on coronary event rates has been demonstrated.

Conclusions:

• Limited evidence suggests triglyceride reduction improves cardiovascular event rates.
• Lowering LDL cholesterol and raising HDL cholesterol are proven therapies for coronary heart disease prevention.
• Management of dyslipidemia prioritizes LDL and HDL cholesterol, with triglyceride reduction as an adjunctive strategy.