Hypertriglyceridemia
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| Hypertriglyceridemia Classification and external resources | |
| ICD-10 | E78.1, E78.2, E78.3 |
|---|---|
| ICD-9 | 272.1 |
| Cardiology Network |
 Discuss Hypertriglyceridemia further in the WikiDoc Cardiology Network |
| Adult Congenital |
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| Cardiac Rehabilitation |
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| Echocardiography |
| Electrophysiology |
| Cardiology General |
| Genetics |
| Health Economics |
| Hypertension |
| Interventional Cardiology |
| MRI |
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| Peripheral Arterial Disease |
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| Pulmonary Embolism |
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In medicine, hypertriglyceridemia (or "Hypertriglyceridaemia") denotes high (hyper-) blood levels (-emia) of triglycerides, the most abundant fatty molecule in most organisms. It has been associated with atherosclerosis, even in the absence of hypercholesterolemia (high cholesterol levels). It can also lead to pancreatitis in excessive concentrations. Very high triglyceride levels may also interfere with blood tests; hyponatremia may be reported spuriously (pseudohyponatremia).
A related term is "Hyperglyceridemia" or "Hyperglyceridaemia", which refers to a high level of all glycerides, including monoglycerides, diglycerides and triglycerides.
Causes include
- Idiopathic (constitutional)
- Obesity
- High sugar diet
- Diabetes mellitus and insulin resistance
- Excess alcohol intake
- Nephrotic syndrome
- Genetic predisposition
Treatment
Treatment of hypertriglyceridemia is by restriction of carbohydrates and fat in the diet, as well as with niacin, fibrates and statins (three classes of drugs). Increased fish oil intake may substantially lower an individual's triglycerides.[1][1][1]
Clinical practice guidelines by the National Cholesterol Education Program (NCEP) suggests that pharmacotherapy be considered with triglycerides are over 200 mg/dl.[1] The guidelines state "the sum of LDL + VLDL cholesterol (termed non-HDL cholesterol [total cholesterol - HDL cholesterol]) as a secondary target of therapy in persons with high triglycerides (200 mg/dL). The goal for non-HDL cholesterol in persons with high serum triglycerides can be set at 30 mg/dL higher than that for LDL cholesterol (Table 9) on the premise that a VLDL cholesterol level 30 mg/dL is normal."[1]
Primary prevention
In the Helsinki Heart Study, a randomized controlled trial of asymptomatic men ages 40-55 without heart disease, 600 mg of gemfibrozil twice daily reduced cardiac endpoints at 5 years from 4.14% to 2.73%. This means that 54 patients must be treated for five years to prevent one cardiac event (number needed to treat is 54).[1]
Secondary prevention
In the Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study (VA-HIT), a randomized controlled trial of men with known heart disease HDL cholesterol of 40 mg/dl or less , 600 mg of gemfibrozil twice daily reduced cardiac endpoints ( nonfatal myocardial infarction or death from coronary causes) at 5 years from 21.7% to 17.3%. This means that 23 patients must be treated for five years to prevent one cardiac event (number needed to treat is 23).[1]
References
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
