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Feature Article

Grappling with hypertriglyceridaemia: Rosetta Stone or Pandora’s Box?

Gerald Watts, Dick C Chan, Gaurav Puri

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Abstract

Hypertriglyceridaemia is caused by interactions between many genetic and nongenetic factors, and is a common risk factor for atherosclerotic cardiovascular disease (CVD). Treatment of hypertriglyceridaemia relies on correcting secondary factors and unhealthy lifestyle habits, particularly poor diet and lack of exercise. Pharmacotherapy is indicated for patients with established CVD and those at moderate-to-high risk of CVD.

Key Points

  • Hypertriglyceridaemia is a common risk factor for atherosclerotic cardiovascular disease.
  • Hypertriglyceridaemia reflects the accumulation in plasma of proatherogenic lipoproteins, triglyceride-rich lipoprotein remnants and small dense LDL particles.
  • Extreme hypertriglyceridaemia (triglyceride levels of more than 20 mmol/L) is rare but significantly increases the risk of pancreatitis.
  • Treatment of hypertriglyceridaemia relies on correcting secondary factors and unhealthy lifestyle habits, particularly poor diet and lack of exercise.
  • Pharmacotherapy is indicated for patients with established cardiovascular disease or individuals at moderate-to-high risk of cardiovascular disease, particularly those with the metabolic syndrome or diabetes.

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