Hypertriglyceridemia

Article Figures & Data

Table 3.

Medications That Elevate Triglycerides

Atypical anti-psychotics

Beta blockers

Bile acid binding resins

Estrogen (in higher dose oral contraceptives and unopposed oral estrogen)

Glucocorticoids

Immunosuppressants

Isotretinoin

Protease inhibitors

Tamoxifen

Thiazides

Table 4.

Strength of Recommendations (SORT)

Key Clinical Recommendations	Strength of Recommendation	References
Obtain fasting lipid panel on patients beginning at 20 years old	C	1
Search for other components of metabolic syndrome in patients with high triglycerides	C	3
Decrease triglycerides to <500 mg/dL to prevent pancreatitis	B	1,4,5
Decrease triglycerides and increase HDL to prevent cardiovascular events	B	9,10

Table 5.

ATP III Adult Lipid Screening Recommendations

Risk Group	Begin Screening	Frequency	Test
CHD^*	20	1 to 2 years	Fasting lipid panel
CHD risk equivalent or 2 or more risk factors^†
Familial dyslipidemia or family history of premature CHD	20	Every 2 years	Fasting lipid panel
No risk	20	Every 5 years	Fasting lipid panel or non-fasting total cholesterol/HDL

* CHD, coronary heart disease; HDL, high-density lipoprotein.
† Risk factors: cigarette smoking, hypertension or taking blood pressure medication, HDL <40, first degree relative with coronary artery disease (men <55, women <65), age (men >45, women >55).

Table 7.

Treatment Guidelines for Hypertriglyceridemia.

Initiate therapeutic lifestyle changes (weight loss/exercise) first
Reduce triglyceride level to less than 500 mg/dL to prevent pancreatitis
Primary aim of medical therapy is to reach LDL^* goal
Secondary aim of therapy is to reach non-HDL goal
In patients with CHD or CHD risk equivalents, tertiary aim of therapy is to reach HDL goal.