Hypertriglyceridaemia: A practical approach for primary care

Hypertriglyceridaemia is commonly encountered in clinical practice and is associated with an increased risk of cardiovascular disease and acute pancreatitis. General practitioners play a central role in treating patients with hypertriglyceridaemia, ultimately with the aim of preventing associated complications.

The aim of this paper is to provide a contemporary approach to the management of patients with hypertriglyceridaemia in Australian primary care.

Hypertriglyceridaemia is often attributable to secondary causes, which should be identified and addressed. Healthy lifestyle modifications targeting diet, exercise, alcohol consumption and weight are fundamental. Statins should be prescribed according to cardiovascular risk assessment and can reduce triglyceride levels. Icosapent ethyl is subsidised on the Pharmaceutical Benefits Scheme and is recommended to reduce cardiovascular risk in statin-treated patients with cardiovascular disease and mild-to-moderate fasting hypertriglyceridaemia (1.7-5.6 mmol/L). In patients with severe hypertriglyceridaemia (>5.6 mmol/L), intensive triglyceride-lowering with lifestyle modifications and pharmacotherapy is recommended to reduce pancreatitis risk. Specialist referral should be considered for severe cases of hypertriglyceridaemia or when primary genetic causes are suspected.