Hypertriglyceridemia and cardiovascular risk reduction.
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.


CONCLUSIONS
Use of strategies to manage TG levels, along with low-density lipoprotein cholesterol levels, is warranted to help reduce the risk of CHD.
Jacobson
Terry A
TA
Office of Health Promotion and Disease Prevention, Emory University, Atlanta, Georgia, USA. Electronic address: tjaco02@emory.edu.
Miller
Michael
M
Division of Cardiology, University of Maryland Medical Center, Baltimore, Maryland, USA.
Schaefer
Ernst J
EJ
Tufts University, Boston, Massachusetts, USA.
D050197:Atherosclerosis / Q000209:etiology / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002995:Clofibric Acid / Q000627:therapeutic use; D003327:Coronary Disease / Q000209:etiology / Q000517:prevention & control; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D015228:Hypertriglyceridemia / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D009525:Niacin / Q000627:therapeutic use; D040242:Risk Reduction Behavior; D045162:Thiazolidinediones / Q000627:therapeutic use
D015525:Fatty Acids, Omega-3; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D045162:Thiazolidinediones; D009525:Niacin; D002995:Clofibric Acid