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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #209698
Title: Hypertriglyceridemia and Cardiovascular Risk Reduction

Author
item JACOBSON, TERRY - EMORY UNIVERSITY
item MILLER, MICHAEL - UNIV OF MARYLAND
item Schaefer, Ernst

Submitted to: Clinical Therapeutics
Publication Type: Review Article
Publication Acceptance Date: 4/1/2007
Publication Date: 5/1/2007
Citation: Jacobson, T.A., Miller, M., Schaefer, E. 2007. Hypertriglyceridemia and Cardiovascular Risk Reduction. Clinical Therapeutics. 29(5):763-77.

Interpretive Summary: Standard measurement of blood fat levels for assessment of heart disease risk includes the measurement of total cholesterol, high density lipoprotein (HDL) cholesterol, triglyceride, and the calculation of low density lipoprotein (LDL) cholesterol. While cholesterol is a waxy substance that can accumulate in blood vessels in the body, triglycerides are important for fuel and are the form in which fat is stored in the body. High levels of blood total cholesterol (> 240 mg/dl), and LDL cholesterol ( > 160 mg/dl) and low levels of HDL cholesterol (< 40 mg/dl in men and < 50 mg/dl in women) have all been associated with increased for coronary heart disease (CHD), the leading cause of death and disability in our society. Elevated blood triglyceride (TG) levels (> 150 mg/dl) are also an important CHD risk factor, especially in women, and are prevalent in about 30% of the US population, especially in those who are overweight, obese, or who have diabetes. Our goal in this article is to review recent data on the population distribution, heart disease risk of high triglyceride levels, and how to treat them with exercise, sugar restriction, weight loss, dietary omega 3 fatty acids, and medications.

Technical Abstract: 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. Meta-analysis indicates that elevated TG levels may be a significant independent risk factor for coronary heart disease (CHD), especially in women. Objective: This goal of this article is to review data bearing on the epidemiology, associated risks, treatment, and prevention of hypertriglyceridemia, including recommended goals and TG-lowering agents. Method: MEDLINE was searched for articles published between 1990 and 2006 using the terms hypertriglyceridemia, dyslipidemia, and coronary heart disease, with subheadings for risk, statins, niacin, fibrates, thiazolidinediones, or omega-3 fatty acids. The reference lists of relevant articles were examined for additional citations. Publications discussing epidemiology, risk, treatment guidelines, clinical trials, and outcomes were selected for review. Results: Concern over the rising rates and deleterious health consequences of hypertriglyceridemia is reflected in the most recent National Cholesterol Education Program guidelines. There is increasing evidence that elevated TGs constitute an independent risk factor for CHD. Several lipid-lowering agents, including statins, fibrates, niacin, thiazolidinediones, and most recently, prescription omega-3 fatty acids are available, and clinical data on their respective efficacy and safety is reviewed. In tandem with lifestyle changes, combination pharmacotherapy to reduce lipid levels, including TGs, may be a useful strategy in managing patients with dyslipidemia. Conclusion: Effective management of TGs, along with low-density lipoprotein cholesterol, is warranted to help reduce the risk of CHD.