From the Guidelines
Elevated triglyceride levels can lead to severe cardiovascular complications and increase the risk of acute pancreatitis, particularly when levels exceed 500 mg/dL. The effects of hypertriglyceridemia are multifaceted, including:
- Increased risk of atherosclerosis, coronary artery disease, and stroke due to arterial plaque formation 1
- Metabolic syndrome components like insulin resistance and fatty liver disease
- Physical manifestations such as eruptive xanthomas, lipemia retinalis, and hepatosplenomegaly
- Significant risk of developing acute pancreatitis, a painful and potentially life-threatening inflammation of the pancreas, especially when triglyceride levels are above 500 mg/dL 1 Treatment depends on the severity of hypertriglyceridemia but typically includes:
- Lifestyle modifications like reducing refined carbohydrates and alcohol, increasing physical activity, and weight loss 1
- Medications such as fibrates, omega-3 fatty acids (icosapent ethyl), statins, and niacin, prescribed based on triglyceride levels and cardiovascular risk 1
- Immediate dietary fat restriction and medication for severe cases (>1000 mg/dL) to prevent pancreatitis 1 Regular monitoring of triglyceride levels is crucial for managing this condition effectively. Key recommendations for managing hypertriglyceridemia include:
- Evaluating for secondary causes of hypertriglyceridemia and considering medical therapy to reduce the risk of pancreatitis for individuals with fasting triglyceride levels ≥500 mg/dL 1
- Addressing and treating lifestyle factors, secondary factors, and medications that raise triglycerides in adults with hypertriglyceridemia 1
- Considering the addition of icosapent ethyl to reduce cardiovascular risk in individuals with ASCVD or other cardiovascular risk factors on a statin with managed LDL cholesterol but elevated triglycerides (150–499 mg/dL) 1
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Effects of Hypertriglyceridemia
- Elevated triglyceride levels are associated with an increased risk of cardiovascular disease (CVD) and acute pancreatitis 2, 3, 4, 5.
- Severely elevated triglyceride levels (500 mg per dL or higher) increase the risk of pancreatitis 2, 4.
- Hypertriglyceridemia is also associated with other risk factors, including obesity, metabolic syndrome, and type 2 diabetes mellitus 2.
Management of Hypertriglyceridemia
- Management of high triglyceride levels starts with dietary changes and physical activity to lower cardiovascular risk 2.
- Lowering carbohydrate intake and increasing fat (especially omega-3 fatty acids) and protein intake can lower triglyceride levels 2.
- Moderate- to high-intensity physical activity can lower triglyceride levels, as well as improve body composition and exercise capacity 2.
- Statins, fibrates, niacin, and omega-3 fatty acids are effective treatments for hypertriglyceridemia 2, 3, 4, 6.
Treatment Options
- Statins are the first line of therapy for the management of mild to moderate hypertriglyceridemia (150-499 mg/dL) 3.
- Fibrates, niacin, or omega-3 fatty acids may be added if elevated triglyceride or non-high-density lipoprotein cholesterol levels persist despite statin therapy 3.
- Omega-3 polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), can reduce plasma triglyceride levels, especially in patients with higher triglyceride levels at baseline 6.