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Hypertriglyceridemia and coronaryheart disease risk
1Preventive Cardiology Center, Rush-Presbyterian-St. Luke's Medical Center, 1725 West Harrison Street, Suite 1159, Chicago, IL 60612, USA. rrosenso@rush.edu
Insights
High triglyceride levels are linked to worsening coronary artery disease and heart disease risk. This article offers a clinical strategy for managing hypertriglyceridemia due to limited treatment data.
Area of Science:
- Cardiology
- Metabolic Disorders
- Lipidology
Background:
- Triglyceride remnant particles correlate with coronary stenosis progression.
- Triglycerides are independently associated with coronary heart disease (CHD) risk, even when accounting for HDL cholesterol.
- Understanding plasma triglycerides requires considering other lipoproteins and fasting/postprandial levels.
Purpose of the Study:
- To present a clinical approach for managing hypertriglyceridemia.
- To address the empirical nature of current triglyceride-lowering recommendations.
- To highlight the need for evidence-based strategies in hypertriglyceridemia management.
Main Methods:
- Review of angiographic-based trials and prospective studies on triglycerides and cardiovascular risk.
- Analysis of the role of plasma triglycerides in the context of other lipoproteins.
- Discussion of fasting and postprandial triglyceride level implications.
Main Results:
- Established association between triglyceride remnant particles and coronary stenosis progression.
- Demonstrated independent association of triglycerides with CHD risk.
- Identified a lack of robust randomized clinical trial data for triglyceride-lowering therapies in CHD prevention.
Conclusions:
- Current recommendations for triglyceride lowering are largely empirical.
- A clinical approach to hypertriglyceridemia management is presented.
- Further research and clinical trials are needed to guide triglyceride-lowering therapies for CHD prevention.
Abstract:
Several angiographic-based trials have established that triglyceride remnant particles are associated with progression of coronary stenosis, and a recent prospective study has shown that triglycerides are associated with coronary heart disease (CHD), even after adjustment for high-density lipoprotein cholesterol. The importance of plasma triglycerides in CHD risk must be interpreted within the context of other plasma lipoproteins, as well as the fasting and postprandial triglyceride levels. Recommendations for triglyceride lowering are empiric because of the lack of randomized clinical trial data that evaluate triglyceride-lowering therapies and CHD prevention. This article presents a clinical approach to the management of hypertriglyceridemia.