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Cited by 50Lipoproteins and Cardiovascular HealthLipid metabolism and disordersDiabetes, Cardiovascular Risks, and Lipoproteins

Treatment options for hypertriglyceridemia: From risk reduction to pancreatitis

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Berglund, Lars, Brunzell, John D., Goldberg, Anne C., Goldberg, Ira J., Stalenhoef, Anton·2014·Best Practice & Research Clinical Endocrinology & Metabolism
DOI 10.1016/j.beem.2013.10.002PMC PMC4028601
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Abstract

While there has been considerable focus on the role and treatment of LDL cholesterol levels, a definitive role of triglycerides in the management of cardiovascular disease has been uncertain. Notably, with increasing triglyceride levels, there is a parallel increase in cholesterol levels carried by triglyceride-rich lipoproteins, which has prompted interest in the use of non-HDL cholesterol levels as a tool guiding interventions. Recent studies have provided evidence for an independent role of triglyceride levels as a cardiovascular risk factor, and recently, an Endocrine Society guideline was published for treatment of hypertriglyceridemia. In contrast to the relative uncertainty regarding triglycerides and cardiovascular disease, a role of very high triglyceride levels as a risk factor for pancreatitis has been well known. The present paper summarizes the underlying evidence for a risk role for triglyceride levels in cardiovascular disease and pancreatitis, current treatment recommendations and areas of future research.

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  • Pharmacological therapies such as fibrates, statins, niacin, and omega-3 fatty acids, as well as lifestyle adjustments, are currently available therapeutic options for controlling hypertriglyceridemia, but often have drawbacks regarding effectiveness, tolerability, and ability to significantly reduce triglyceride levels necessary to lower cardiovascular risk.

    “Pharmacological therapies such as fibrates, statins, niacin, and omega-3 fatty acids, as well as lifestyle adjustments, are currently available therapeutic options for controlling hypertriglyceridemia. Nevertheless, these therapies often have drawbacks regarding their effectiveness, tolerability, and ability to significantly reduce triglyceride levels necessary to lower cardiovascular risk [4,5].”

    From Efficacy and safety of Olezarsen in treating hypertriglyceridemia: a systematic review and meta-analysis of randomized controlled trials (2025) · cites this paper as [4]

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References 105 · Cited by 50

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  1. [1]Stamler J Diet and coronary heart disease Biometrics 1982 38 Suppl 95 118 7046825
  2. [2]Keys A Menotti A Aravanis C Blackburn H Djordevic BS Buzina R Dontas AS Fidanza F Karvonen MJ Kimura N The seven countries study: 2,289 deaths in 15 years Preventive medicine 1984 13 141 154 6739443
  3. [3]Baigent C Blackwell L Emberson J Holland LE Reith C Bhala N Peto R Barnes EH Keech A Simes J Collins R Efficacy and safety of more intensive lowering of ldl cholesterol: A meta-analysis of data from 170,000 participants in 26 randomised trials Lancet 2010 376 1670 1681 21067804 PMC2988224
  4. [4]Lorenzo C Williams K Hunt KJ Haffner SM The national cholesterol education program - adult treatment panel iii, international diabetes federation, and world health organization definitions of the metabolic syndrome as predictors of incident cardiovascular disease and diabetes Diabetes care 2007 30 8 13 17192325
  5. [5]Third report of the national cholesterol education program (ncep) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel iii) final report Circulation 2002 106 3143 3421 12485966
  6. [6]Grundy SM Cleeman JI Daniels SR Donato KA Eckel RH Franklin BA Gordon DJ Krauss RM Savage PJ Smith SC Jr Spertus JA Costa F American Heart A, National Heart L, Blood I Diagnosis and management of the metabolic syndrome: An american heart association/national heart, lung, and blood institute scientific statement Circulation 2005 112 2735 2752 16157765
  7. [7]Franco OH Massaro JM Civil J Cobain MR O’Malley B D’Agostino RB Sr Trajectories of entering the metabolic syndrome: The framingham heart study Circulation 2009 120 1943 1950 19884471
  8. [8]Global recommendations for the management of dyslipidemia. Full report An International Atherosclerosis Society Position Paper 2013 24528685
  9. [9]Zheng C Khoo C Furtado J Sacks FM Apolipoprotein c-iii and the metabolic basis for hypertriglyceridemia and the dense low-density lipoprotein phenotype Circulation 2010 121 1722 1734 20368524 PMC3153990
  10. [11]Tabas I Williams KJ Boren J Subendothelial lipoprotein retention as the initiating process in atherosclerosis: Update and therapeutic implications Circulation 2007 116 1832 1844 17938300
  11. [13]Huang-Doran I Sleigh A Rochford JJ O’Rahilly S Savage DB Lipodystrophy: Metabolic insights from a rare disorder The Journal of endocrinology 2010 207 245 255 20870709
  12. [14]Szendroedi J Roden M Ectopic lipids and organ function Current opinion in lipidology 2009 20 50 56 19133412
  13. [16]Summary of the second report of the national cholesterol education program (ncep) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel ii) JAMA: the journal of the American Medical Association 1993 269 3015 3023 8501844
  14. [17]Heiss G Tamir I Davis CE Tyroler HA Rifkand BM Schonfeld G Jacobs D Frantz ID Jr Lipoprotein-cholesterol distributions in selected north american populations: The lipid research clinics program prevalence study Circulation 1980 61 302 315 7351055
  15. [18]Ford ES Giles WH Dietz WH Prevalence of the metabolic syndrome among us adults: Findings from the third national health and nutrition examination survey JAMA: the journal of the American Medical Association 2002 287 356 359 11790215
  16. [20]Wildman RP Muntner P Reynolds K McGinn AP Rajpathak S Wylie-Rosett J Sowers MR The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: Prevalence and correlates of 2 phenotypes among the us population (nhanes 1999–2004) Archives of internal medicine 2008 168 1617 1624 18695075
  17. [21]Centers for Disease C, Prevention Prevalence of abnormal lipid levels among youths --- united states, 1999–2006 MMWR Morbidity and mortality weekly report 2010 59 29 33 20094024
  18. [23]Brunzell JD Schrott HG The interaction of familial and secondary causes of hypertriglyceridemia: Role in pancreatitis J Clin Lipidol 2012 6 409 412 23009776
  19. [24]Chait A Brunzell JD Severe hypertriglyceridemia: Role of familial and acquired disorders Metabolism: clinical and experimental 1983 32 209 214 6827992
  20. [25]Murphy MJ Sheng X MacDonald TM Wei L Hypertriglyceridemia and acute pancreatitis JAMA internal medicine 2013 173 162 164 23183821
  21. [26]Zilversmit DB Atherogenesis: A postprandial phenomenon Circulation 1979 60 473 485 222498
  22. [30]Mora S Rifai N Buring JE Ridker PM Fasting compared with nonfasting lipids and apolipoproteins for predicting incident cardiovascular events Circulation 2008 118 993 1001 18711012 PMC2574817
  23. [31]Eberly LE Stamler J Neaton JD Multiple Risk Factor Intervention Trial Research G Relation of triglyceride levels, fasting and nonfasting, to fatal and nonfatal coronary heart disease Archives of internal medicine 2003 163 1077 1083 12742806
  24. [33]Warnick GR Nakajima K Fasting versus nonfasting triglycerides: Implications for laboratory measurements Clinical chemistry 2008 54 14 16 18039717
  25. [35]Lee SJ Moye LA Campos H Williams GH Sacks FM Hypertriglyceridemia but not diabetes status is associated with vldl containing apolipoprotein ciii in patients with coronary heart disease Atherosclerosis 2003 167 293 302 12818412
  26. [39]Peterfy M Ben-Zeev O Mao HZ Weissglas-Volkov D Aouizerat BE Pullinger CR Frost PH Kane JP Malloy MJ Reue K Pajukanta P Doolittle MH Mutations in lmf1 cause combined lipase deficiency and severe hypertriglyceridemia Nature genetics 2007 39 1483 1487 17994020
  27. [42]Brunzell JD Clinical practice. Hypertriglyceridemia The New England journal of medicine 2007 357 1009 1017 17804845
  28. [44]Austin MA McKnight B Edwards KL Bradley CM McNeely MJ Psaty BM Brunzell JD Motulsky AG Cardiovascular disease mortality in familial forms of hypertriglyceridemia: A 20-year prospective study Circulation 2000 101 2777 2782 10859281
  29. [45]Veerkamp MJ de Graaf J Hendriks JC Demacker PN Stalenhoef AF Nomogram to diagnose familial combined hyperlipidemia on the basis of results of a 5-year follow-up study Circulation 2004 109 2980 2985 15184285
  30. [46]Genest JJ Jr Martin-Munley SS McNamara JR Ordovas JM Jenner J Myers RH Silberman SR Wilson PW Salem DN Schaefer EJ Familial lipoprotein disorders in patients with premature coronary artery disease Circulation 1992 85 2025 2033 1534286
  31. [47]Mahley RW Huang Y Rall SC Jr Pathogenesis of type iii hyperlipoproteinemia (dysbetalipoproteinemia). Questions, quandaries, and paradoxes Journal of lipid research 1999 40 1933 1949 10552997
  32. [48]Alberti KG Eckel RH Grundy SM Zimmet PZ Cleeman JI Donato KA Fruchart JC James WP Loria CM Smith SC Jr International Diabetes Federation Task Force on E, Prevention, Hational Heart L, Blood I, American Heart A, World Heart F, International Atherosclerosis S, International Association for the Study of O Harmonizing the metabolic syndrome: A joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; american heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity Circulation 2009 120 1640 1645 19805654
  33. [50]Nieves DJ Cnop M Retzlaff B Walden CE Brunzell JD Knopp RH Kahn SE The atherogenic lipoprotein profile associated with obesity and insulin resistance is largely attributable to intra-abdominal fat Diabetes 2003 52 172 179 12502509
  34. [53]Carr MC Knopp RH Brunzell JD Wheeler BS Zhu X Lakshmanan M Rosen AS Anderson PW Effect of raloxifene on serum triglycerides in women with a history of hypertriglyceridemia while on oral estrogen therapy Diabetes care 2005 28 1555 1561 15983300
  35. [56]Stone NJ Secondary causes of hyperlipidemia The Medical clinics of North America 1994 78 117 141 8283927
  36. [57]Brinton EA Effects of ethanol intake on lipoproteins and atherosclerosis Current opinion in lipidology 2010 21 346 351 20616714
  37. [58]Garg A Agarwal AK Lipodystrophies: Disorders of adipose tissue biology Biochimica et biophysica acta 2009 1791 507 513 19162222 PMC2693450
  38. [63]Anuurad E Bremer A Berglund L Hiv protease inhibitors and obesity Current opinion in endocrinology, diabetes, and obesity 2010 17 478 485 PMC3076638 20717021
  39. [64]Hakeam HA Al-Jedai AH Raza SM Hamawi K Sirolimus induced dyslipidemia in tacrolimus based vs. Tacrolimus free immunosuppressive regimens in renal transplant recipients Annals of transplantation: quarterly of the Polish Transplantation Society 2008 13 46 53 18566560
  40. [71]Vu-Dac N Gervois P Torra IP Fruchart JC Kosykh V Kooistra T Princen HM Dallongeville J Staels B Retinoids increase human apo c-iii expression at the transcriptional level via the retinoid x receptor. Contribution to the hypertriglyceridemic action of retinoids The Journal of clinical investigation 1998 102 625 632 9691099 PMC508923
  41. [72]Casey DE Dyslipidemia and atypical antipsychotic drugs The Journal of clinical psychiatry 2004 65 Suppl 18 27 35 15600382
  42. [75]Austin MA Triglyceride, small, dense low-density lipoprotein, and the atherogenic lipoprotein phenotype Current atherosclerosis reports 2000 2 200 207 11122745
  43. [77]Baigent C Keech A Kearney PM Blackwell L Buck G Pollicino C Kirby A Sourjina T Peto R Collins R Simes R Cholesterol Treatment Trialists C Efficacy and safety of cholesterol-lowering treatment: Prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins Lancet 2005 366 1267 1278 16214597
  44. [78]Mora S Advanced lipoprotein testing and subfractionation are not (yet) ready for routine clinical use Circulation 2009 119 2396 2404 19414657 PMC2735461
  45. [79]Erqou S Kaptoge S Perry PL Di Angelantonio E Thompson A White IR Marcovina SM Collins R Thompson SG Danesh J Emerging Risk Factors C Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality JAMA: the journal of the American Medical Association 2009 302 412 423 19622820 PMC3272390
  46. [80]Anuurad E Enkhmaa B Berglund L Enigmatic role of lipoprotein(a) in cardiovascular disease Clinical and translational science 2010 3 327 332 21167011 PMC3075492
  47. [81]Mensink RP Zock PL Kester AD Katan MB Effects of dietary fatty acids and carbohydrates on the ratio of serum total to hdl cholesterol and on serum lipids and apolipoproteins: A meta-analysis of 60 controlled trials The American journal of clinical nutrition 2003 77 1146 1155 12716665
  48. [83]Ludwig DS The glycemic index: Physiological mechanisms relating to obesity, diabetes, and cardiovascular disease JAMA: the journal of the American Medical Association 2002 287 2414 2423 11988062
  49. [84]Furtado JD Campos H Sumner AE Appel LJ Carey VJ Sacks FM Dietary interventions that lower lipoproteins containing apolipoprotein c-iii are more effective in whites than in blacks: Results of the omniheart trial The American journal of clinical nutrition 2010 92 714 722 20826623 PMC2937582
  50. [89]Sharma M Ansari MT Abou-Setta AM Soares-Weiser K Ooi TC Sears M Yazdi F Tsertsvadze A Moher D Systematic review: Comparative effectiveness and harms of combination therapy and monotherapy for dyslipidemia Annals of internal medicine 2009 151 622 630 19884623
  51. [90]Graham DJ Staffa JA Shatin D Andrade SE Schech SD La Grenade L Gurwitz JH Chan KA Goodman MJ Platt R Incidence of hospitalized rhabdomyolysis in patients treated with lipid-lowering drugs JAMA: the journal of the American Medical Association 2004 292 2585 2590 15572716
  52. [91]Abourbih S Filion KB Joseph L Schiffrin EL Rinfret S Poirier P Pilote L Genest J Eisenberg MJ Effect of fibrates on lipid profiles and cardiovascular outcomes: A systematic review The American journal of medicine 2009 122 962 e961 968 19698935
  53. [95]Brown BG Zhao XQ Chait A Fisher LD Cheung MC Morse JS Dowdy AA Marino EK Bolson EL Alaupovic P Frohlich J Albers JJ Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease The New England journal of medicine 2001 345 1583 1592 11757504
  54. [97]Bhardwaj SS Chalasani N Lipid-lowering agents that cause drug-induced hepatotoxicity Clinics in liver disease 2007 11 597 613 vii 17723922 PMC2048990
  55. [98]Musa-Veloso K Binns MA Kocenas AC Poon T Elliot JA Rice H Oppedal-Olsen H Lloyd H Lemke S Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid dose-dependently reduce fasting serum triglycerides Nutrition reviews 2010 68 155 167 20384846
  56. [99]Harris WS Ginsberg HN Arunakul N Shachter NS Windsor SL Adams M Berglund L Osmundsen K Safety and efficacy of omacor in severe hypertriglyceridemia Journal of cardiovascular risk 1997 4 385 391 9865671

Authors
Berglund, L., Brunzell, J. D., Goldberg, A. C., Goldberg, I. J., & Stalenhoef, A.
Affiliations
  • VA Northern California Health Care System (US)
  • University of Washington (US)
  • Washington University in St. Louis (US)
  • Columbia University Irving Medical Center (US)
  • Radboud University Medical Center (NL)
Corresponding author
Berglund, Lars
ORCID
Venue
Best Practice & Research Clinical Endocrinology & Metabolism
Publisher
Elsevier BV
Published
2014-06
Volume
28
Issue
3
Pages
423-437
ISSN
1521-690X (ISSN-L)
DOI
10.1016/j.beem.2013.10.002
PMC
PMC4028601
OpenAlex
W1967610778
Cited by
50
References
105
Citations by year
2026: 1 · 2025: 5 · 2024: 4 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 5 · 2019: 4 · 2018: 5 · 2017: 8 · 2016: 2 · 2015: 7 · 2014: 1
FWCI
0.59
Type
journal article
Language
en
Open access
Licence
Locations
  • Best Practice & Research Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Funders
  • National Institutes of Health (UL1TR000002)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
hypertriglyceridemia, triglycerides, cardiovascular risk, pancreatitis, non-HDL cholesterol, triglyceride-rich lipoproteins, LDL cholesterol, treatment guidelines, Endocrine Society guidelines
MeSH terms
Cardiovascular Diseases, Diagnostic Techniques, Endocrine, Humans, Pancreatitis, Risk Factors, Triglycerides, Hypertriglyceridemia, Risk Reduction Behavior

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