Management of Mild-to-Moderate Hypertriglyceridemia

Objective: Hypertriglyceridemia (HTG) is highly prevalent globally, and its prevalence is rising, with a worldwide increase in the incidence of obesity and diabetes. This review examines its current man-agement and future therapies.Methods: For this review, HTG is defined as mild-to-moderate elevation in the levels of triglyceride (TG): a fasting or nonfasting TG level of >= 150 mg/dL and <500 mg/dL. We reviewed scientific studies published over the last 30 years and current professional society recommendations regarding the evaluation and treatment of HTG. Results: Genetics, lifestyle, and other environmental factors impact TG levels. In adults with mild-to -moderate HTG, clinicians should routinely assess and treat secondary treatable causes (diet, physical activity, obesity, metabolic syndrome, and reduction or cessation of medications that elevate TG levels). Because atherosclerotic cardiovascular disease risk is the primary clinical concern, statins are usually the first-line treatment. Patients with TG levels between >= 150 mg/dL and <500 mg/dL whose low-density lipoprotein cholesterol is treated adequately with statins (at maximally tolerated doses, per some statements) and have either prior cardiovascular disease or diabetes mellitus along with at least 2 additional cardiovascular disease risk factors should be considered for added icosapent ethyl treatment to further reduce their cardiovascular disease risk. Fibrates, niacin, and other approved agents or agents under development are also reviewed in detail.Conclusion: The treatment paradigm for mild-to-moderate HTG is changing on the basis of data from recent clinical trials. Recent trials suggest that the addition of icosapent ethyl to background statin therapy may further reduce atherosclerotic cardiovascular disease risk in patients with moderate HTG, although a particular TG goal has not been identified.(c) 2022 AACE. Published by Elsevier Inc. All rights reserved.

Automated summary

This review examines the current management and future therapies for hypertriglyceridemia (HTG), a highly prevalent and rising condition globally. The findings suggest that clinicians should assess and treat secondary causes of mild-to-moderate HTG and consider statins as the first-line treatment. Recent clinical trials also indicate that adding icosapent ethyl to statin therapy may further reduce the risk of atherosclerotic cardiovascular disease in patients with moderate HTG.